全髋关节置换术治疗DDH继发骨关节炎的近期疗效观察

目的探讨采用全髋置换术治疗成人先天性髋关节发育不良伴继发性骨关节炎的经验及近期疗效。方法 2004年3月至2009年4月,采用全髋置换术治疗先天性髋关节发育不良继发骨关节炎患者15例19髋,其中男性2例2髋,女性13例17髋,年龄37～62岁,平均45.6岁。根据Crowe分类[1],型8髋,型6髋,型3髋,型2髋。结果随访时间为8个月～5年（平均2年9个月）,术后无感染、脱位、假体松动等并发症发生。Harris评分由术前47.6分恢复到术后86.2分,患髋疼痛完全消失,关节活动功能满意。结论全髋关节置换术是治疗成人先天性髋关节发育不良伴继发性骨关节炎的有效方法,术前完善的影像学检查,术中充分的软组织松解、原解剖位置重建髋臼、适当的植骨以及选择合适的假体,是手术成功的关键。

Short-term Effects of Total Hip Replacement for Osteoarthritis Secondary to Acetabular Dysplasia

Objective To summarize the experiences of total hip replacement in the treatment of osteoarthritis secondary to acetabular dysplasia in adults and to evaluate its early effects.Methods From March 2004 to April 2009,19 hips in 15 adult patients with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement were included in this study.Of the patients,2 hips in 2 patients were male and 17 hips in 13 patients were female.Their ages ranged from 37 to 62 years with an average age of 45.6 years.8 were type Ⅰ,6 were type Ⅱ,3 were type Ⅲ,2 were type Ⅳ according to the Crowe classification.Results The duration of follow-up ranged from 8 months to 5 years（average 2years and 9 months）.The average Harris score was increased from 47.6 to 86.2 points,All the patients were pain-free and there was no sign ＂infection loosening dislocation or subsidence＂.Conclusion Total hip replacement is effective method for the treatment of osteoarthritis secondray to acetabular dysplasia in adults.The key point to the success for operation are perfect imaging examination preoperative,appropriate joint components,soft tissue release and improved the techniques of bone graft in the acetabulum.