人工髋关节置换治疗强直性脊柱炎髋关节病变的临床疗效分析

【目的】探讨人工全髋关节置换术治疗强直性脊柱炎的疗效。【方法】对34例（45髋）强直性脊柱炎患者行人工全髋关节置换术，其中男24例，女10例，年龄20～75岁，平均40岁。采用国际医学科学组织委员会国际诊断标准进行疾病诊断，随访平均3年。【结果】术后疗效根据Merled Aubigneand Postel评分标准。术后除了2例患者外，病人有轻微疼痛或者无疼痛，髋关节活动范围增加了平均45．5度。对于关节纤维强直的患者，术后髋关节屈曲改善了平均57．3度。对于术前活动范围局限在室内的10例患者，9例活动范围明显得到改善，但是需要指出的是强直性脊柱患者术后行走功能较其它疾病的患者要差。术后无深静脉血栓、假体松动、断裂以及脱位发生。异位骨化发生率15．6％（7髋），但对功能无明显影响。【结论】人工全髋关节置换术治疗强直性脊柱炎可以明显缓解髋关节疼痛，恢复关节功能，但与其它病因的全髋关节置换术相比，具有很高的骨化性肌炎发生率。

Effect of total hip arthroplasty therapy on ankylosing spondylitis

Objective] The purpose of this study was to evaluate the results in a consecutive group of patients with ankylosing spondylitis who underwent total hip arthroplasty （THA） . Methods] The results of forty - five total hip arthroplasties in thirty - four patients with ankylosing spindylitis were reviewed. There were twenty - four men and ten women, with an average age of forty years （range , twenty to seventy- five years） at the time of the arthroplasty. The diagnosis of ankylosing spondylitis was estab- lished preoperatively with use of Council for International Organization of Medical Science （CIOMS）o The average duration of fol- low up was three years. Results] The results were analyzed according to the criteria of Merled Aubigne and Postel. Postopera- tively all but two patients either were pain - free or had only mild pain （grades 4 ~ 6） o The average ranges of motion in all hip joints is improved by 45.5 degrees, in the patients who had bone ankylosis, the average arc of flexion achieved was 57.3 degrees. ten patients were confined to the house before surgery , nine patients had little or no restriction of outdoor walking, but it must be pointed out that most of these patients had restricted function in wakling when compared with the normal individual, all patient had not deep vein thrombosis. There was no sign of loosening, dislocation or fracture of the prosthesis. According to the system of Brooker, the incidence of heterotopic ossification was 15. 6% （7 hips）. Conclusions] THA in patient with ankylosing spendylitis provided excellent pain relief and reconstruct the function of hip joint. Compared with THA operated for other cause of disease, patient with ankylosing spondylitis are at increased risk for the development of heterotopic ossification.