全髋关节置换术治疗伴有股骨头坏死的成人髋关节发育不良-东南大学学报医学版

全髋关节置换术治疗伴有股骨头坏死的成人髋关节发育不良

单位：中国医科大学附属盛京医院骨科, 辽宁沈阳 110004

分类号：R681.6

出版年·卷·期（页码）：2012·31·第三期（309-313）

摘要：

目的:总结人工全髋关节置换术治疗伴有股骨头坏死的成人髋关节发育不良的经验及术后效果。方法:分析我科2006年4月至2010年6月间诊治的29位伴有股骨头坏死的成人髋关节发育不良患者的临床资料及随访结果,并进行统计学处理。共行38髋全髋关节置换术,平均随访20个月。结果:平均手术时间109 min,平均术中失血量390 ml,围术期无重大心脑血管并发症发生,平均Harris评分术前为39.3分,术后随访为84.3分(P<0.05),手术效果优良率为96%。结论:全髋关节置换术是治疗伴有股骨头坏死的成人髋关节发育不良的一种重要方法,术者对该病病理特点的熟练掌握、周密的术前准备、丰富的手术经验是手术取得成功的关键。

Objective: To discuss the experience and the efficacy of total hip arthroplasty in adult developmental hip dysplasia accompanied with femoral head necrosis. Methods: We reviewed 38 total hip arthroplasty performed in our institution, out of which 29 patients diagnosed as developmental hip dysplasia accompanied with femoral head necrosis.Their clinical and follow-up data was statistically analyzed using SPSS 15.0. Results: Average operation time was 109 minutes,average blood loss was 390 ml, no severe cardiovascular complications was found, the average Harris hip score was 39.3 before operation compared with 84.3 when following-up, the excellent and good rate averaged 96%. Conclusion: Total hip arthroplasty should be an important method to treat the adult patients suffering from developmental hip dysplasia accompanied with femoral head necrosis, which requires skillful master of the pathological characteristics, meticulous preoperative preparation and profound experience of the surgeons.

参考文献：

[1] ARONSON J.Osteoarthritis of the young adult hip:etiology and treatment.USA: American Academy of Orthopaedic Surgeons, 1986, 35:119-128.
[2] 王红强,吉士俊.髋关节发育不良的病理演变[J],中国矫形外科杂志,2002,10(12):1222-1224.
[3] STAHELI L T.Surgical management of acetabular dysplasia[J].Clin Orthop,1991,264:111-121.
[4] PAPACHRISTOU G,HATZIGRIGORIS P,PANOUSIS K,et al.Total hip arthroplasty for developmental hip dysplasia[J].International Orthopaedics,2006,30:21-25.
[5] 朱振安,戴尅戎,王友,等.全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节脱位的临床研究[J].中华外科杂志,2006,44(20):1403.
[6] CROWE J F,MANI V J,RANAWAT C S.Total hip replacement in congenital dislocation and dysplasia of the hip[J].J Bone Joint Surg Am,1979,61:15-23.
[7] DEARBORN J T,HRRIS W H.High placement of acetabular component inserted without cement in a reversion total hip arthroplasty:results after a mean of ten years[J].J Bone Joint Surg(Am),1999,81:469-480.
[8] RAJIV G,ANTHONY M,FOROUGH F,et al.Computer navigation in total hip replacement:a meta-analysis[J].International Orthopaedics,2009,33:593.
[9] CARSTEN P,ULRIKE F,WILLIAM R,et al.Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup[J].J Bone Joint Surg Am,2004,86:312-319.
[10] NERCESSIAN O A,MACAULAY W,STINCHFIELD F E.Peripheral neuropathies following total hip arthroplasty[J].J Arthroplasty,1994,9:645.
[11] GARVIN K L,BOWEN M K,SALVATI E A,et al.Long term results of total hip arthroplasty in congenital dislocation and dysplasia of the hip:a follow-up note[J].J Bone Joint Surg(Am),1991,73:1348.
[12] 赵文志,郑连杰,何盛为,等.全髋关节置换术治疗成人高位先天性髋关节脱位[J].中国骨与关节损伤杂志,2007,22:491.
[13] 刘兴炎,葛宝丰,甄平,等.全髋关节置换治疗伴有股骨头坏死的成人先天性髋关节脱位[J].中国骨关节损伤,2008,23(6):462.
[14] 张学军,王宸.人工关节置换术后假体无菌性松动的研究进展[J].现代医学,2009,37(1):70-72.

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