不同材质人工全髋关节置换重建成人大骨节病性髋关节功能的比较

背景：既往对Ⅱ、Ⅲ度大骨节病患者行关节清理等来矫正畸形,但常不能收到满意效果。目的：比较不同材质人工全髋关节置换治疗成人大骨节病性髋关节骨性关节炎的疗效。方法：回顾性分析2006-03/2010-05哈尔滨医科大学附属第四医院骨科收治的大骨节病性髋关节骨性关节炎患者13例（20髋）,均进行人工全髋关节置换治疗,5髋采用骨水泥型假体,15髋采用非骨水泥型假体。结果与结论：13例患者均获随访,随访时间8～48个月。两组患者置换后第14天和末次随访Harris评分较置换前显著提高,差异有显著性意义（P〈0.05）,骨水泥型假体与非骨水泥型假体患者置换后Harris评分相比差异无显著性意义（P〉0.05）。随访期内X射线平片未见异位骨化、假体松动、下沉等现象,无翻修病例。置换后髋痛消失,步态正常,无严重并发症。提示使用不同材质的人工全髋关节置换治疗大骨节病性髋关节骨性关节炎,均可明显缓解疼痛,改善髋关节功能,矫正畸形,提高患者生活质量。

Comparison of different materials of total hip arthroplasty for reconstruction of hip function in adult Kaschin-Beck disease

BACKGROUND：There are non-excellent outcomes with limited arthroscopic clean-up in patients with adult Kaschin-Beck disease.OBJECTIVE：To compare the curative effect of different materials in total hip arthroplasty for patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease.METHODS：A total of 20 hips with total hip replacements were performed in 13 patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease from March 2006 to May 2010.There were 5 cases receiving bone cement prosthesis and 15 cases receiving non-bone cement prosthesis.RESULTS AND CONCLUSION：The mean follow-up was 8-48 months.Compared with preoperation,the mean Harris hip scores on the 14th day after the operation and at the last follow-up were all improved significantly（P 0.05）.There was no significant difference between bone cement prosthesis and non-bone cement prosthesis（P 0.05）.There was no loosening,migration,heterotopic ossification radiographically,and no revision during the follow-up.Total hip arthroplasty can alleviate the joint ache and improve joint movable function.Different-material total hip arthroplasty is an effective treatment for patients with secondary hip osteoarthritis due to adult Kaschin-Beck disease.