强直性脊柱炎行全髋置换术的手术策略

Strategy of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis

目的随访全髋置换术(THA)治疗强直性脊柱炎(AS)的中期结果,探讨该病行THA的策略。方法46例(52髋)AS患者行THA治疗,术后随访1.1～6.6年,比较手术前后关节疼痛、活动度和Harris评分,分析对不同身体条件患者行不同类型THA策略。结果获得随访40例(46髋),42髋疼痛明显缓解,关节活动度由术前平均34.7°改善为术后79.7°。髋关节屈曲畸形由术前平均28.5°改善为6.8°。术前Harris评分平均47.2分,术后平均87分。结论THA治疗AS可获得满意的效果,但术前的个体化分析、选择不同的手术策略和假体对手术效果至关重要。

Objective To study the strategy of total hip arthroplasty （THA） in patients with ankylosing spondylitis （AS） by evaluating intermediate--term results. Methods Forty - six hips of 40 patients with AS undergoing THA were reviewed. The mean follow - up was 3.7 years （range, 1.1 to 6.6 years）. The preoperatively and postoperatively comparative study on pain, range of motion, and total function evaluation were conducted. The clinical results were evaluated by the Harris hip seorring system. Results Pain relief was obtained in 42 hips. Mean range of motion was improved from 34.7°to 79.7°and the flexion deformity of the involved hip was corrected from mean 28.5° to 6.8°. Conclusion The results of THA in AS are satisfactory. It is very significant to analyze the patients in different conditions, to choose proper strategy, and to choose the suitable prothesis for the definite patients.