全髋关节置换术治疗髋臼发育不良继发骨关节炎22例的效果观察.docVIP

全髋关节置换术治疗髋臼发育不良继发骨关节炎22例的效果观察 　　 　　 　　[摘要] 目的 探讨全髋关节置换术治疗髋臼发育不良继发骨性关节炎的术后效果。 方法 22例（24髋）髋臼发育不良继发骨性关节炎患者行全髋关节置换术，观察疗效。 结果 术后2年随访，24髋中优10髋，良12髋，中2髋，优良率为91.7%；Harris髋关节评分由术前的（41.9±7.3）分提升到术后（85.7±11.2）分；随访期间未见感染及假体不稳定等并发症。 结论 全髋关节置换术是治疗髋臼发育不良继发骨性关节炎的有效方法。 　　[关键词] 髋臼发育不良；骨关节炎；全髋关节置换术 　　[中图分类号] R684.3[文献标识码] B[文章编号] 1674-4721（2014）03（c）-0183-03 　　 　　Effect observation of total hip arthroplasty in the treatment of acetabular dysplasia secondary osteoarthritis in 22 cases 　　WANG Hao 　　People′s Hospital of Tongbai County in Henan Province,Tongbai 474750,China 　　[Abstract] Objective To explore the postoperative effect of total hip arthroplasty in the treatment of acetabular dysplasia secondary osteoarthritis. Methods 22 (24 hips) patients of acetabular dysplasia secondary osteoarthritis were conducted the total hip arthroplasty,and the curative effect were observed. Results All patients were followed-up for 2 years after operation,among 24 hips,10 hips were excellent,12 hips were good and 2 hips were medium,the rate of excellent and good was 91.7%;Harris hip joint score from (41.9±7.3) points before operation enhanced to (85.7±11.2) points after operation;during follow-up,no infection and no complications such as prosthesis instability were found. Conclusion Total hip arthroplasty is an effective method of treating acetabular dysplasia secondary osteoarthritis. 　　[Key words] Acetabular dysplasia;Osteoarthritis;Total hip arthroplasty 　　髋臼发育不良是造成髋关节骨性关节炎的常见原因，患者髋臼发育缺陷造成髋关节生物力学异常，负重区软骨渐进性退变，晚期出现继发性骨关节炎，患者髋部疼痛明显、活动受限，严重影响生活质量。全髋关节置换术（total hip arthroplasty，THA）近年来被日益广泛地应用于治疗髋臼发育不良导致的骨性关节炎[1]。2006年6月～2013年8月，本院对不同程度的髋臼发育不良继发骨关节炎患者实施了THA，观察其术后效果。 　　1 资料与方法 　　1.1 一般资料 　　本组22例24髋，女20例（22髋），男2例（2髋）；年龄36～68岁，平均（57.4±10.2）岁；其中双侧2例，单侧20例。患者均髋部持续疼痛，功能受限，活动时明显加重。Harris髋关节评分，平均（41.9±7.3）分。术前X线检查显示均为严重骨性关节炎。参照Crowe分型，其中髋关节发育不良Ⅰ度4髋，Ⅱ度10髋，Ⅲ度8髋，Ⅳ度2髋。 　　1.2术前准备 　　术前行髋关节CT扫描，了解股骨近段的形态学改变和髋臼的结构变化，测量髋臼角及CE角度数，制订髋臼重建方案。根据患者的骨质情况选择型号合适的股骨假体和人工髋臼，设计假体安放的位置。同时向患者和家属解释手术方案，争取术后配合进行