大直径陶瓷-陶瓷全髋关节置换术治疗强直性脊柱炎髋关节病变.docVIP

大直径陶瓷－陶瓷全髋关节置换术治疗强直性脊柱炎髋关节病变 【摘要】目的 评价应用大直径陶瓷-陶瓷股骨头人工全髋关节置换术治疗强直性脊柱炎（AS）髋关节病变的早期临床疗效。方法 对25例（40髋）AS累及髋关节的患者行大直径陶瓷-陶瓷股骨头人工全髋关节置换术，术后定期随访，比较手术前后髋关节屈伸活动度、Harris评分及影像学变化。结果 本组2例因骨质疏松术中出现股骨近端骨折，用钢丝捆绑，8周复查骨折愈合。患者均获随访，术后平均随访1.8年（1～4年），髋关节屈伸活动度由术前平均为（27.5±18.6）°上升为术后（89.3±15.4）°，Harris评分由术前（31.2±10.8）分上升为术后（91.7±12.5）分。无感染、关节脱位、深静脉血栓形成等并发症发生，X线 检查无假体松动和移位。异位骨化3例，Brooker 1级2例，Brooker 2级1例。结论 大直径陶瓷－陶瓷全髋关节置换术治疗AS髋关节病变能够明显缓解患者症状，改善关节功能，近期疗效满意。 【关键词】关节成形术，置换，髋；脊柱炎，强直性；陶瓷制品 The short-term outcome of large-diameter ceramic-on-ceramic femoral head prothesis for ankylosing spondylitis 【Abstract】Objective To evaluate the short term clinical outcome of large-diameter ceramic-on-ceramic femoral head prothesis for ankylosing spondylitis. Methods 25 patients with 40 hips were performed with large-diameter ceramic-on-ceramic femoral head prothesis, and all patients were followed up. The preoperative and postoperative motion of hip joint in flexion, Harris score and X-ray examination were compared. Results Intraoperatively, 2 patients suffering from proximal femur fracture due to severe osteoporosis were treated with steel wire fixation, and the fractures were healed 8 weeks later. All the patients were followed up for average 1.8 years ranging from 1 to 4 years . The motion of hip joint in flexion increased from （27.5±18.6）°preoperative to （89.3±15.4）°postoperative, and the average Harris hip score increased from （31.2±10.8）preoperative to （91.7±12.5）postoperative. There were no complications such as infection, dislocation and deep vein thrombosis. All cases had no prosthesis displacement and loosening in X-ray. Acetabular heterotopic ossification was seen in 3hips, 2 were Brooker grade 1, 1 was grade 2. Conclusions Large-diameter ceramic-on-ceramic femoral head prothesis has a good short-term effect in treatment of ankylosing spondylitis, which can relieve symptoms and improve joint function significantly. 【Key words】Arthroplasty, replacement, hip; Spondylitis, ankylosing; Ceramics 强