全髋置换术治疗髋关节继发性骨关节炎80例分析

目的：探讨成人髋关节继发性骨关节炎的发病机制和手术方式。方法：2003年9月～2006年12月我科收治髋关节继发性骨关节炎患者80例（96髋）,术前结合影像学明确诊断,其中股骨头缺血性坏死（AFHN）56例（68髋）,成人髋臼发育不良（DDH）24例（28髋）。所有患者均行全髋置换术,对AFHN和DDH分别根据病理机制实施相应手术操作。比较手术前后的髋关节功能Harris评分,评估人工全髋置换术的临床疗效。结果：术后平均随访4.2年,Harris评分平均为86.3分,有1例假体失败行翻修手术,余患者手术效果满意。结论：全髋关节置换术是治疗髋关节继发骨关节炎的有效方法,术前应明确诊断,术中根据不同原发疾病采用相应的手术操作。

Total Hip Arthroplasty for the Treatment of Secondary Osteoarthritis in Hip

Objective：To summarize the techniques of total hip arthroplasty （THA） in the treatment of secondary osteoarthritis with different etiological factors.Methods：80 patients with secondary hip osteoarthritis were treated by THA with a cementless cup from September 2003 to December 2006. The diagnosis was made according to history, clinical examination and radiological findings. The primary diseases resulting in hip osteoarthritis included avascular femoral head necrosis （AFHN, in 56 cases） and developmental dysplasia of acetabulum （DDH, in 24 cases）. Corresponding surgical procedure was applied during THA according to the etiological factors. Harris score pre-and post-operation was used to evaluate the clinical outcome. Results：All patients were followed up for 4.2 years averagely, and the mean Harris score was 86.3. One patient, misdiagnosed as AFHN before the operation, was found prothesis dislocation and underwent revision. Conclusion：It is effective to use THA procedures for secondary osteoarthritis in hip. Corresponding surgical procedure should be taken according to the primary disease.