强直性脊柱炎强直髋全髋关节置换术45例临床分析

目的观察强直性脊柱炎髋关节受累强直时行全髋关节置换术的临床疗效。方法对2003年1月2008年1月45例（78髋）强直性脊柱炎患者行全髋关节置换术,其中38例（55髋）进行了平均4.5年（2～7年）的随访。结果 38例患者术后髋关节功能均明显改善,Harris评分由术前（16.3±1.7）分提高到术后（83.4±4.6）分。髋关节屈曲畸形矫正,55个髋关节总活动度（屈伸、内收、外展、内旋、外旋等6个方向活动总和）由术前（38.7±7.6）°增加至术后（191.2±10.3）°。术后髋关节疼痛消失,膝关节痛、腰骶部疼痛明显改善,步态较术前改善,生活自理。结论短期随访全髋关节置换术治疗强直性脊柱炎髋关节受累强直安全、有效。

Clinical Analysis of Total Hip Arthroplasty for 45 Cases with Ankylosing Spondylitis

Objective To observe the effect of total hip arthroplasty （THA） in patients with ankylosing spondylitis （AS）. Methods A total of 78 THA were performed in 45 patients with AS, and 38 patients （55 hips） were followed retrospectively with an average follow-up period of 4.5 years （ranged from 2 to 7 years）. The clinical results were evaluated by the Harris hip scoring system and radiographic analysis between January 2003 and January 2008. Results The function of all the hip joints was improved, and the postoperative Harris Score were 83.4±4.6 versus the preoperative Harris Score of 16.3±1.7. The serious flexion deformity of the involved hips was disappeared. The average range of motion of hip joint was （191.2±10.3）°. The pain of the hips released mostly and pain of lower waists and knees was released obviously. Patients got their gait right and could take care of themselves approximately. Conclusion THA is an effective method in treating patients of ankylosing spondylitis with stiff hips.