摘要
[目的]观察全髋关节置换术(total hip arthroplasty,THA)中髋臼高位放置治疗CroweⅡ型、Ⅲ型髋关节发育不良(developmental dysplasia of the hips,DDH)的临床疗效。[方法]回顾性分析2014年2月~2016年10月本院收治的行THA治疗的21例(28髋)CroweⅡ型和Ⅲ型DDH患者(高位放置组),以同期19例(26髋)接受THA治疗的CroweⅠ型DDH患者为对照(解剖位放置组)。采用Trendelenburg征和Harris髋关节评分评价临床效果,拍摄双髋关节正侧位X线片,测量髋关节旋转中心距泪滴的垂直距离和水平距离、下肢长度差异。[结果]高位放置组手术时间和术中出血量均低于解剖位放置组,差异有统计学意义(P<0.05)。术后2年时,CroweⅠ型、CroweⅡ型和CroweⅢ型DDH患者Harris评分的差异无统计学意义(P>0.05)。术后所有患者步态良好,无跛行发生,Trendelanburg征均为阴性。所有患者X线片均未见放射性透亮线和假体下沉,高位放置组和解剖位放置组双下肢长度差值比较差异无统计学意义。CroweⅡ型和Ⅲ型患者髋关节旋转中心距泪滴的垂直距离均高于CroweⅠ型患者(P<0.05),而组间水平距离的比较差异无统计学意义(P>0.05)。[结论]THA术中髋臼高位放置治疗CroweⅡ型、Ⅲ型DDH的效果较好,未来需要扩大样本量,并进行长期随访,以证实本研究结论。
[Objective]To evaluate the clinical outcomes of high acetabular placement in total hip arthroplasty(THA)for Crowe type II and III developmental dysplasia of the hip(DDH)in adult.[Methods]A retrospective study was made on 21 patients(28 hips)who underwent high acetabular placement THA for Crowe type II and III DDH in our hospital from February2014 to October 2016.In addition,19 patients(26 hips)who received anatomical acetabular placement THA for Crowe type I DH treated with THA in the same period group were set up as the control group.The Trendelenburg sign and Harris score were applied for assessment of the clinical consequences,and radiographs were taken to measure the vertical and horizontal distances between the rotation center of the hip joint and the tear drop and the length of the lower limbs.[Results]The operation time and intraoperative bleeding in the high placement group were significantly less than those in the anatomical placement group(P<0.05).At 2 years after operation,there was no significant difference in Harris scores among Crowe type I,Crowe type II and Crowe type III DDH patients(P>0.05).All patients achieved good gait without obvious limp,while with a negative Trendelanburg sign.No radiolucent line and prosthesis subsidence were noticed on X-ray films in all patients.There was no significant difference in the length difference of lower limbs between the high position group and the anatomical position group.The vertical distance between hip rotation center and tear drop in Crowe type II and III patients was higher than that in Crowe type I patients(P<0.05),but there was no significant difference in horizontal distance between groups(P>0.05).[Conclusion]The high acetabular placement THA is an effective technique for Crowe type II and type III DDH in adult in this study.It needs further studies with expanded the sample size and lengthened the follow up period to confirm this conclusion in future.
作者
万安营
唐淼
刘忠堂
亓文静
WAN An-ying;TANG Miao;LIU Zhong-tang(Department of Orthopaedics,Suzhou Affiliated Hospital,An hui Medical University,Suzhou 234000,China;Department of Joint Surgery,Changhai Hospital,Shanghai 200433,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第1期36-40,共5页
Orthopedic Journal of China
基金
国家自然科学基金项目(编号:81371936).
关键词
髋关节发育不良
成人
全髋关节置换术
髋臼高位放置
hip developmental dysplasia of the hip(DDH)
adult
total hip arthroplasty(THA)
high acetabular placement
