全髋关节置换术治疗髋关节强直疗效分析

目的：探讨髋关节强直患者行全髋关节置换术的特点及临床疗效。方法2005年7月-2011年7月对61例（70髋）髋关节强直（Ankylosed Hip）的患者实施全髋关节置换术，患者在术后1、3、6、12个月及此后每年1次随访，采用 Harris 评分标准及放射学评价临床效果。结果所有髋关节强直的患者行全髋关节置换术（THA）手术治疗，手术时间50～90 min，平均65．4 min，术中出血量100～400 mL，平均194．8 mL，61例患者均获随访，时间12～73个月，平均32个月。Harris 评分由术前的平均（41．3±15．8）分提高到末次随访时平均（86．5±13．4）分，其中优25髋（35．7％），良36髋（51．4％），中4髋（5．7％），差5髋（7．2％），手术优良率为87．1％，手术前后差异有统计学意义（P ＜0．05）。术中、术后未出现假体周围骨折、感染等并发症，随访期内未出现松动翻修病例。结论全髋关节置换术是治疗由各种原因引起的髋关节强直的一种有效方法。如若髋关节骨性融合，手术难度较大，则术前准备应充分。

Total hip arthroplasty in the ankylosed hip

Objective To study the characteristics and clinical outcomes of total hip arthroplasty （THA）in patients with ankylosed hip.Methods 61 patients （70 hips）with AH underwent THA from February 2005 to July 2011 were reviewed retrospectively.All of the patients were followed-up.Radiographic and clinical evaluations were taken at 1 month,3 months,6 months,12 months after operation and then once a year postoperatively.All patients were evaluated using Harris score standardization and Radiography.Re-sults The average time of the operation was 65.4 minutes （ranging from 50 to 90 minutes）,the average volume of bleeding in the operation was 194.8 mL （ranging from 100 to 400 mL）.All of these patients were followed for average 32 months （ranging from 12 to 73 months）.The average Harris score was （86.5 ±13.4）at the latest follow-up,and there was statistical difference compared with the preoperative score （P 〈0.05）.The rate of excellent and good was 87.1%.Conclusion The THA is a very effective treatment for patients with AH.If the hip joint is osseous fusion,the operation would be very difficult.So there should be a sufficient preoperative preparation.