强直性脊柱炎非骨水泥型全髋关节置换术临床分析

目的探讨强直性脊柱炎患者行人工非骨水泥型全髋关节置换的手术时机、手术方法及疗效分析。方法自2000年对27例33髋强直性脊柱炎后髋关节强直的患者经Gibson入路行人工非骨水泥型全髋关节置换术，其中男21例27髋，女6例6髋；年龄19—37岁，平均32．9岁。术前Merle D’Aubigne评分平均6．9分（3-8分）。结果27例33髋均获得随访，平均随访21个月（5-46个月）。假体位置良好，无脱住，髋关节疼痛消失。各向运动良好。患者评分平均17．3分（16—18分）。结论对强直性脊柱炎可放宽手术年龄限制，根据患者的不同情况，在术中采取恰当的关节置换技术，均可恢复髋关节功能，提高生活质量，取得满意的疗效。

Total hip arthroplasty for treatment of ankylosing spondylitis

Objective] To discuss the operating opportunity and method and curative effect of the total hip arthroplasty(THA) surgery technique for treatment of ankylosing spondylitis(AS) patients. Methods] Since 2000, we performed the THA for 27 AS patients (male 21 coxa 27, female 6 coxa 6), the average age was 32.9(range from 19 to 37). The mean preoperative Merle D'Aubigne score was 6.9 (range from 3 to 8). Results] There was no dislocation and pain after the THA. The X-ray showed that the prosthesis were in good place. After 5~46 months follow-up(mean 21 months), the Merle D'Aubigne score was 17.3 in average (range from 16 to 18). Conclusion] As to AS patients, if we perform the THA with the correct technique, the coxa function all can be improved and the patients can acquire better life quality.