目的探讨改良Ilizarov髋重建术治疗青年髋关节疾患的临床疗效。方法回顾性分析2010年1月-2018年3月采用改良Ilizarov髋重建术治疗的13例青年髋关节疾病患者临床资料。其中男2例,女11例;年龄14~34岁,平均24.2岁。脊柱裂后遗髋部发育不良...目的探讨改良Ilizarov髋重建术治疗青年髋关节疾患的临床疗效。方法回顾性分析2010年1月-2018年3月采用改良Ilizarov髋重建术治疗的13例青年髋关节疾病患者临床资料。其中男2例,女11例;年龄14~34岁,平均24.2岁。脊柱裂后遗髋部发育不良伴脱位1例,髋关节化脓性关节炎后遗髋发育不良3例,发育性髋关节发育不良(developmental dysplasia of the hip,DDH)伴股骨头坏死拒绝行髋关节置换2例,青年发育性髋关节脱位拒绝行髋关节置换6例,痉挛型脑瘫致双髋发育不良伴脱位1例。病程2~20年,平均8.5年。术前Trendelenburg征阳性12例,阴性1例。术前髋关节Harris评分为(53.5±8.9)分,双下肢不等长为(46.08±15.73)mm。术后行髋关节Harris评分,并根据患者自行打分评价疗效满意度。结果 13例患者术后均获随访,随访时间1~5年,平均2.6年。5例患者出现术后针道感染,经换药后感染控制;7例出现膝关节活动受限,经膝关节功能锻炼后改善。术后1年患者Harris评分为(84.5±6.1)分,较术前显著改善(t=-10.538,P=0.000);根据Harris评分评价疗效,获优4例、良5例、可4例,优良率69.2%。双下肢不等长为(15.38±7.27)mm,较术前显著改善(t=11.826,P=0.000)。末次随访时患者疗效满意度评分为80%~95%,平均88%。结论改良Ilizarov髋重建术可应用于治疗不适合或拒绝行人工髋关节置换术的青年髋关节疾病患者,其疗效可靠,在重建髋关节以及改善患肢跛行、纠正肢体短缩等方面具有独特优势。展开更多
We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. Sh...We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.展开更多
文摘目的探讨改良Ilizarov髋重建术治疗青年髋关节疾患的临床疗效。方法回顾性分析2010年1月-2018年3月采用改良Ilizarov髋重建术治疗的13例青年髋关节疾病患者临床资料。其中男2例,女11例;年龄14~34岁,平均24.2岁。脊柱裂后遗髋部发育不良伴脱位1例,髋关节化脓性关节炎后遗髋发育不良3例,发育性髋关节发育不良(developmental dysplasia of the hip,DDH)伴股骨头坏死拒绝行髋关节置换2例,青年发育性髋关节脱位拒绝行髋关节置换6例,痉挛型脑瘫致双髋发育不良伴脱位1例。病程2~20年,平均8.5年。术前Trendelenburg征阳性12例,阴性1例。术前髋关节Harris评分为(53.5±8.9)分,双下肢不等长为(46.08±15.73)mm。术后行髋关节Harris评分,并根据患者自行打分评价疗效满意度。结果 13例患者术后均获随访,随访时间1~5年,平均2.6年。5例患者出现术后针道感染,经换药后感染控制;7例出现膝关节活动受限,经膝关节功能锻炼后改善。术后1年患者Harris评分为(84.5±6.1)分,较术前显著改善(t=-10.538,P=0.000);根据Harris评分评价疗效,获优4例、良5例、可4例,优良率69.2%。双下肢不等长为(15.38±7.27)mm,较术前显著改善(t=11.826,P=0.000)。末次随访时患者疗效满意度评分为80%~95%,平均88%。结论改良Ilizarov髋重建术可应用于治疗不适合或拒绝行人工髋关节置换术的青年髋关节疾病患者,其疗效可靠,在重建髋关节以及改善患肢跛行、纠正肢体短缩等方面具有独特优势。
文摘We present a case of a 71-year-old woman with unexplained instability of her total hip arthroplasty 12 years after implantation due to loosening of the ceramic component of a sandwich ceramic in polyethylene liner. She experienced in total 2 dislocations in 6 months. These events occurred without fracture of the ceramic liner. Sandwich ceramic liners were introduced with the idea of combining the benefits of ceramic and polyethylene bearings in total hip arthroplasty in order to reduce wear and to allow a ceramic on ceramic bearing to be used in a cup designed for polyethylene inserts only. Although some reports showed promising early results, case reports and later on retrospective analysis showed high fracture rates of the ceramic liner component. We believe that loosening of the ceramic component may precede fracture of the liner and that a ceramic on ceramic configuration is preferable.
