摘要
目的探讨人工全髋关节置换术治疗成人髋关节发育不良伴骨性关节炎的手术方法及近期临床疗效。方法2012年1月至2014年12月,对55例（79髋）行人工全髋关节置换术治疗的成人髋关节发育不良伴骨性关节炎患者进行疗效分析,其中男21例,女34例,单侧31例,双侧24例,平均年龄51岁（19-76岁）。按Crowe分型,Ⅰ型21例27髋,Ⅱ型17例26髋,Ⅲ型12例20髋,Ⅳ型5例6髋。主要临床表现为髋部疼痛及跛行。分别通过Harris评分及X线检查评估患者临床疗效及影像学指标。结果平均手术时间（118±15）min,平均出血量（345±91）m L,术后所有患者均获随访,平均随访时间（26±8）个月,术前、术后1周及术后3月Harris评分分别为（48.8±11.8）分、（71.8±5.9）分、（90.2±4.0）分,两两比较差异均有统计学意义（P〈0.05）,术后肢体较术前平均延长（2.2±0.7）cm。X线检查提示所有患者假体位置均安放良好。随访期内有1例患者出现一过性坐骨神经牵拉损伤表现,4周后自行恢复,所有患者均未出现脱位、深静脉血栓、异位骨化、假体周围感染及骨折、假体松动及下沉等并发症。结论全髋关节置换术治疗成人髋关节发育不良伴骨性关节炎的近期疗效确切,可有效解除患者疼痛、改善其功能。
Objective To evaluate the surgical method and short-term clinical efficacy of total hip replacement surgery for adult dysplasia of hip joint with osteoarthritis.Methods 55 adult patients with dysplasia of hip joint associated with osteoarthritis underwent total hip replacement surgery in the hospital from January 2012 to December 2014 were enrolled,including 21 males,34females and the mean age was 51 years. Among these 55 patients,31 had unilateral hip dysplasia and the other 24 had bilateral hip dysplasia. We divided the patients into four types according to the Crowe classification. 27 hip joints in 21 cases were divided into type I,and 26 hips in 17 cases into type II,20 hips in 12 cases into type III,6 hips in 5 cases into type IV. The main clinical manifestations of these patients were hip pain and limp. And we used Harris score and X-ray examination to assess the clinical efficacy and radiographic parameters.Results The mean operation time was（ 118±15） min and the average blood loss was（ 345 ± 91） m L.All patients were followed up for an average period of（ 26± 8） months（ months）. The Harris scores of preoperative,1 week and 3months after operation were（ 48. 8±11. 8） points,（ 71. 8±5. 9） points,（ 90. 2±4. 0） points respectively and the pairwise comparisons showed significant differences（ P〈0. 05）.And postoperative limb extended at an average length of（ 2. 2±0. 7） cm. X-ray examinations showed that all the prostheses were well placed. During follow-up period,1 patient developed transient sciatic nerve traction injury. And the injury performance disappeared automatically after 4 weeks. Complications like dislocation,deep venous thrombosis,heterotopic ossification,infection,periprosthetic-fracture,prostheses loosening and sink did not happen in all the patients. Conclusion Total hip replacement surgery had definite short-term clinical efficacy for adult patients with hip dysplasia associated with osteoarthritis.
出处
《四川医学》
CAS
2016年第11期1279-1283,共5页
Sichuan Medical Journal
