微创人工关节置换治疗髋关节强直.docVIP

微创人工关节置换治疗髋关节强直 闫 飞，陈光兴，杨 柳，戴 刚，古凌川，王文斌，何 锐，王富友，张 颖，张 一（400038 重庆，第三军医大学西南医院关节外科中心） [摘要] 目的 探讨微创全人工关节置换治疗髋关节强直的疗效。方法 2006年6月至2009年7月，13例（21髋）髋关节强直患者在微创入路下行人工全髋关节置换，年龄20~66岁（平均46岁），病因为：强直性脊柱炎5例（10髋），类风湿性关节炎4例（6髋），股骨头无菌性坏死继发严重骨性关节炎2例（3髋），髋关节感染后遗强直畸形2例（2髋）。患者患髋均无活动度，均选用生物型人工关节，13髋为解剖头金属对金属界面，8髋为陶瓷对陶瓷界面。结果 手术顺利，手术时间(80±12)min(最短60min)，术中出血量(380±156)ml。 所有患者术后均获得随访，随访时间12~48个月，术后X线评价人工关节位置良好，术中无骨折，术后无假体松动、关节脱位、感染及深静脉栓塞等并发症。Harris评分：术前(45.6±6.2)分，术后至最后1次随访(86.6±7.3)分，差异有统计学意义（P＜0.05）。结论 对于外展肌功能存在的髋关节强直患者行微创人工关节置换，能有效改善髋关节功能，提高患者生活质量，创伤小，恢复快。 [关键词]强直；关节成形；髋关节；微创 Minimally Invasive Total Hip Arthroplasty for Stiff Hip Yan Fei,Chen Guangxing,Yang Liu,Dai Gang,Gu Lingchuan,Wang Wenbin, He Rui, Wang Fuyou,Zhang Ying, Zhang Yi(Center for Joint Surgery, Southwest Hospital, Third Military Medical University, 400038, China) [Abstract]Objective To discuss the techniques and the effect of minimally invasive on total hip arthroplasty for stiff hip. Methods From June 2006 to July 2009,13 patients(21hips) with stiff hip received in total hip arthroplasty with minimally invasive techniques, and their age between 20 years and 66 years（mean, 46 years）,with contraction function of abducent muscle.The cause of stiffness include that ten hips(5 patients) are from spinal akylosis;six hips(4 patients) are from rheumatoid arthritis;three hips(2 patients) are secondary from AVN of the femoral head,and two hips(2 patients) are from deformity after infection.Their prosthesis include metal to metal large femoral head(13 hips) and ceramic to ceramic(8 hips) . Results These cases were successed and performed with surgery time of (80±12) min (minimum 60 minutes). Blood loss during operation was (380± 156)ml. All patients abtained follow-up from 12 months to 48 months, with good prosthesis location by X-ray, no fracture in operating, no dislocation, infection, DVT, and other complication. Harris score after operation improved obviously: preoperative(45.6±6.2)points and the latest postoperative(86.