短颈直柄型股骨假体治疗高位脱位型髋关节发育不良的临床应用

[目的]探讨高位脱位型髋关节发育不良继发骨关节炎的患者,应用短颈直柄型股骨假体进行人工全髋置换的临床体会。[方法]2002年6月～2007年10月,对11例(12髋)高位脱位型髋关节发育不良继发骨关节炎的患者,应用短颈直柄型股骨假体实施人工全髋关节置换术。所有患者均为女性,平均年龄51(41～68)岁。手术采用髋关节后外侧入路,髋臼重建于真正的髋臼窝,根据宿主骨对臼杯的包容情况予以结构性自体植骨;股骨侧应用短颈直柄型假体,骨水泥固定。术中进行广泛的软组织松解。[结果]本组病例患髋旋转中心较术前平均下降4.5(3.8～4.8)cm,患肢平均延长3.9(3.6～4.3)cm。术后平均随访36(10～66`)个月,所有结构性植骨均获得愈合,患髋未出现假体松动,股骨假体的骨-水泥界面及假体-水泥界面均未见透亮线。术后均未出现坐骨神经、股神经麻痹。Harris评分由术前的平均41.8分提高到术后的平均86.2分。[结论]对于术前计划髋关节旋转中心下移不超过5cm的高位脱位型髋关节发育不良继发骨关节炎患者,应用短颈直柄型股骨假体进行人工全髋置换,避免了股骨截骨短缩和大转子截骨,近期效果满意。

Clinical application of total hip arthroplasty with a short-neck and straight stem for treatment of developmental dysplastic hip with high dislocation

[Objective] To evaluate clinical effect of total hip arthroplasty(THA)with a short-neck and straight stem in patients with osteoarthritis secondary to developmental dysplastic hip with high dislocation.[Methods]From June 2002 to October 2007,total hip arthroplasties with a short-neck and straight stem were performed for 11 patients(12 hips)with osteoarthritis secondary to developmental dysplastic hip with high dislocation.All were females with an average age of 51 years(range from 41 to 68 years).The operat...