人工全髋关节置换治疗髋臼内陷症的早期疗效

目的探讨人工全髋关节置换治疗髋臼内陷症的方法及早期疗效。方法 2006年1月-2010年2月,收治髋臼内陷症16例16髋。男6例,女10例;年龄39～72岁,平均56.5岁。病程1年6个月～35年,中位病程6.4年。左髋7例,右髋9例。原发性3例,继发性13例。髋关节Harris评分为(49.5±5.5)分。髋臼内陷按Dunlop等的诊断标准分度:轻度3例,中度9例,重度4例。患者均行人工全髋关节置换,髋臼重建时采用植骨及非骨水泥型髋臼假体恢复患髋股骨偏心距及髋臼旋转中心。结果术后16例切口均Ⅰ期愈合,无感染及下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间12～62个月,平均37个月。末次随访时,髋关节Harris评分为(90.5±4.5)分,与术前比较差异有统计学意义(t=49.578,P=0.000)。X线片显示假体位置良好,无松动、下沉,植骨与髋臼融合,无髋臼再次内陷。结论人工全髋关节置换治疗髋臼内陷时,采用植骨及非骨水泥型髋臼假体恢复患髋股骨偏心距及髋臼旋转中心,可获满意早期疗效。

Early effectiveness of total hip arthroplasty in treating protrusio acetabuli

Objective To evaluate the method and the early effectiveness of total hip arthroplasty in the treatment of protrusio acetabuli.Methods Between January 2006 and February 2010,16 cases(16 hips) of protrusio acetabuli were treated,including 6 males and 10 females with an average age of 56.5 years(range,39-72 years).The median disease duration was 6.4 years(range,1 year and 6 months to 35 years).Involved hips included 7 left hips and 9 right hips;3 patients had primary protrusio acetabuli and 13 patients had secondary protrusio acetabuli.The preoperative Harris score was 49.5 ± 5.5.According to Dunlop et al.classification criterion,there were 3 cases of mild,9 cases of moderate,and 4 cases of severe.All patients received total hip arthroplasty with bone graft and cementless prosthesis for recovery of femoral offset and acetabular center of rotation.Results All incisions healed by first intention without complication of infection,deep venous thrombosis,or nerve injury.All patients were followed up 12-62 months with an average of 37 months.The Harris score at last follow-up was 90.5 ± 4.5,showing significant difference(t=49.578,P=0.000) when compared with preoperative score.The X-ray films showed that no prosthesis loosening or subsidence was observed,and bone graft healed with no sign of re-protrusion.Conclusion In treatment of protrusio acetabuli,total hip arthroplasty with bone graft and cementless prosthesis can recover the femoral offset and acetabular center of rotation and provide satisfactory early effectiveness