先天性髋臼发育不良继发骨性关节炎的外科治疗

目的 探讨Zweymuller 型人工全髋关节假体置换治疗先天性髋臼发育不良继发髋关节骨性关节炎的有效性。方法 应用Zweymuller型人工全髋关节假体，对29例32个先天性髋臼发育不良继发髋关节骨性关节炎患者行全髋关节置换（THR）。患者全部为女性，单侧26例，双侧3例。Perner分型度17例，19个髋，Ⅱ度7例，7个，Ⅲ度4例，5个髋，Ⅳ度1例，1个髋。平均随访27．5个月，术前Harris评分最高59分，最低25分，平均44．5分.结果所有患者髋关节疼痛完全消失，关节活动度增加，Harris评分最高97分，最低63分，平均85分。结论 特殊设计的Zweymuller型人工全髋关节假体置换初期稳定，手术不需大块植骨和骨水泥，初期随访效果满意。

Primary Zweymuller total hip arthroplasty for osteoarthritis secondary to congenital acetabular dysplasia

OBJECTIVE: To evaluate the effectiveness of Zweymuller prothesis in replacing osteoarthritis secondary to congenital dysplasia of the hip. METHODS: From January 1996 to June 2000, Zweymuller prothesis was used to reconstruct 32 hips in 29 patients with congenital acetabular dysplasia(3 bilateral cases). All patients were female. According to the classification of Perner, 19 hips belonged to type I, 7 type II, 5 type III, and 1 type IV. The mean follow-up period was 27.5 months (6-53 months). The preoperative Harris hip score ranged from 25 to 59(average 44.5). RESULTS: The pain was completely relieved, and the Harris hip score ranged from 63 to 97(average 85). CONCLUSION: We consider that the Zweymuller total hip arthroplasty provides stable fixation of the cup in the presence of moderate acetabular dysplasia without structural bone grafting or cementing.