全髋关节置换术治疗成人先天性髋关节脱位的临床疗效分析

Treatment of congenital dislocated hip by total hip replacement

目的 探讨全髋关节置换术治疗成人先天性髋关节脱位伴骨性关节炎的经验。方法2003年8月至2005年9月，对16例（20髋）成人先天性髋关节脱位伴骨性关节炎患者进行了全髋关节置换。其中双侧4例，单侧12例。平均年龄38岁（33～53岁）。结果术后伤口均一期愈合，随访6～48个月，平均32．6个月；平均Harris评分由术前的44．7分恢复到术后1年的91．3分。术后5个月，患者均能下地行走，生活自理且恢复日常工作。结论 全髋关节置换术是治疗成人先天性髋关节脱位伴骨性关节炎的有效方法，但手术难度较大。对于此类患者，充分理解全髋置换的复杂性和细致周密的治疗方案是成功的关键。

Objective To explore the experiences of total hip replacement in treating osteoarthritis secondary to congenital dislocation of the hip. Methods From Aug. 2003 to Nov. 2005, twenty hips in sixteen adult patients with osteoarthritis secondary to congenital dislocation of the hip undergone total hip replacement were included in this study. There were 4 patients in bilateral hip and 12 patients in unilateral hip. The age of the patients at surgery ranged from 33 - 53 years （mean age is 38 years）. Results The incision healed well. The duration of follow up ranged from 6 months to 48 months （mean period is 32.6 month）. All patients could walk independently, take care of themselves and return to previous job in 5 months post-operation. The average Harris score increased from 44.7 to 91.3 points in one year after operation. Conclusion Total hip replacement is an effective method in treating osteoarthritis secondary to congenital dislocation of the hip and is a challenging work to the orthopaedic surgeon. It is critical to understand the complexities of total hip replacement and to plan the operative intervention meticulously.