强直髋合并髋臼内陷的手术策略及临床疗效观察.DOCVIP

全髋置换术治疗强直髋合并髋臼内陷的临床疗效观察 万修阳 ，刘永辉1，邓 念1 ，尚奎大 2 ，孙东宁1 ，邢志军1 ，袁红艳1 ，张 良1 （266000 山东 青岛，青岛市海慈医疗集团创伤骨科1，266033，山东 青岛，平度市人民医院2） [摘要] 目的 探讨全髋置换术治疗强直性脊柱炎后期强直髋合并髋臼内陷症的围手术期管理、手术策略、中远期疗效观察。方法 2003 年 7 月-2013 年10 月，对19例（共23髋）实施生物型人工全髋置换术。其中男性 16例，女性3 例，双髋病例4例。年龄 32 ～ 65 岁，平均 41.5岁。组内患者AS病程至手术前为10～42 年，平均病程22.3年；术前术后进行Harris评分。测量肢体长度及髋臼指数，记录患髋活动度。结果 术后共有19例患者得到随访，平均随访时间65.2个月。末次随访Harris评分（87.1± 5.5）分，有统计学意义（P＜0.01）。 结论 人工全髋关节置换术治疗髋臼内陷症安全有效，髋臼重建尽可能使用植骨术及非骨水泥假体，以获得更好的中远期疗效。 [关键词] 强直性脊柱炎；髋强直；髋臼内陷；全髋置换；髋臼重建 [中图法分类号] [文献标志码] A Clinincal outcomes of artificial hip replacement for Ankylosed hip complicated with acetabular protrusion Wan Xiuyang，Liu Yonghui，Deng Nian,Shang Kuida,Sun Dongning,Xing Zhijun,Yuan Hongyan,Zhang Liang （266000 QingDao 1Hiser Medical Center OF QingDao，2660332 Peoples Hospital of PingDu ,266000） [Abstract] Objective To evaluate peri- operation period management,operation strategy and the medi-term effectiveness of total hip arthroplasty in the treatment of ankylosed hip complicated with protrusio acetabuli in later stage of ankylosing Spondylitis(AS) . Methods Between July 2003 and October 2013, 19 cases (23 hips) of ankylosed hip complicated with protrusio acetabuli were treated with cementless total hip arthroplasty , including16 males and 3 females ,4 bilater hip patients with an average age of 41.5 years (range, 32-65 years). The AS disease duration was 22.3 years (range, 10 year to 42 years). Clinical results were evaluated w ith Harris scores, Limb length and acetabular index were assessed w ith anterior-posterior. Results 21 patients were followed up 65.2 months. The Harris score at last follow-up was 87.1± 5.5, showing signiffcant difference （P＜0.01) when compared with preoperative score. The X-ray showed that all acetabular prosthesis were in true acetabulum, and bone graft healed with no sign of re-protrusion. Conclusion Total hip arthroplasty Intreatment of Ankylosing Spondylitis(AS) complicatede w