全髋关节置换与髋关节表面置换治疗髋臼骨折后骨关节炎的疗效研究

目的比较全髋关节置换和髋关节表面置换对髋臼骨折后骨关节炎的临床疗效。方法将菏泽市立医院2008年1月至2010年5月收治的髋臼骨折后创伤性关节炎患者61例(61髋)随机分为全髋关节置换组(31例)和髋关节表面置换组(30例),术后评定髋关节功能。结果随访时间为9个月至5.5年,所有患者髋关节活动显著改善,疼痛症状消失或明显好转,无神经血管损伤、假体松动、关节脱位、下肢深静脉血栓形成、股骨颈骨折等并发症发生。全髋关节置换组3髋有X线片透亮区,1髋有局灶性骨溶解。髋关节表面置换组术后髋关节屈伸活动度大于全髋关节置换组,差异有统计学意义(P<0.05)。结论髋臼骨折后创伤性关节炎的年轻患者和对运动要求较高的老年患者,可选择髋关节表面置换术,术后关节功能改善明显,髋关节屈伸活动度较好。

Study on the Curative Effect of Total Hip Replacement and Hip Resurfacing for Osteoarthritis after Acetabular Fracture

Objective To compare clinical curative effect of total hip replacement and hip resurfacing for osteoarthritis after acetabular fracture.Methods 61 patients(61 hips) with osteoarthritis after acetabular fractures from Heze Municipal Hospital during January 2008 to May 2010 were randomly divided into total hip replacement group(31 cases)and hip resurfacing group(30 cases),hip function were evaluated after the operation.Results Follow-up time was 9 months to 5.5 years,hip activities of all patients have improved markedly,pain symptoms disappeared or improved obviously,no complications of neurovascular injury,prosthesis loosening,joint dislocation,lower extremity deep vein thrombosis,and femoral neck fracture occurred.In total hip replacement group 3 hips were with X-ray bright area,1 hip was with a focal bone dissolving.Hip resurfacing group hip flexion activities degree was greater than total hip replacement group,the difference was statistically significant(P<0.05).Conclusion Hip resurfacing can be chosen for younger patients or elder patients with higher requirement for activity to treat osteoarthritis after acetabular fractures,which may improve postoperative joint function significantly,and realize better degrees of hip flexion and extension activities.