先天性和陈旧性髋关节脱位的全髋置换术

Total hip arthroplasty for congenital and old hip dislocation

目的探讨先天性髋关节脱位和陈旧性髋关节脱位患者人工全髋关节置换术的适应证和髋臼假体安放位置的选择。方法先天性髋关节脱位10例(13髋)和陈旧性髋关节脱位6例(6髋),均采用改良Gibson入路,髋臼假体安放在髋关节假臼位置,关闭切口时尽可能修复髋关节周围软组织结构。结果16例均经1～3年随访,疗效评定参照Charnley标准,关节功能优10例(11髋),良好3例(5髋),可3例(3髋)。结论先天性髋关节脱位和陈旧性髋关节脱位人工全髋关节置换术的髋臼假体位置的选择不能一概而论,应根据移位的远近、骨质条件和重建软组织平衡的难易程度而定。

Objective To investigate the indication, alterative of implant site of the acetabular prosthesis of congenital and old hip dislocation. Methods 10 patients（ 13 hips）were congenital dislocation and 6 patients（6 hips）were old hip dislocation. All the patients were operated with the Gibson approach and implanted the prosthesis at the false acetabular, and repaired the soft tissue around the hip joint when closing the incision. Results All the 16 patients were followed up for 1 - 3 years. According to Chamley curative effect standard, clinical results were excellent in 10 patients （ 11 hips）, good in 3 patients （ 5 hips）, fair in 3 patients （ 3 hips）. Conclusions About total hip arthroplasty for congenital and old hip dislocation,implantation the acetabular prosthesis should be done at different site according to the condition of the bone, extend of the dislocation, the balance of the soft tissue around the hip.