全髋关节置换术后对单侧髋关节发育不良患者腰痛症状的影响

Effect of total hip replacement on lumbago in unilateral developmental hip dysplasia

目的评价单侧成人髋关节发育不良全髋关节置换术后患者腰痛症状的变化。方法2001年1月至2006年1月，对39例合并腰痛的单侧成人髋关节发育不良患者行全髋关节置换术，其中男性7例，女性32例，患者平均年龄53岁（38～73岁）。CroweⅠ型4例，CroweⅡ型20例，Ⅲ型8例，Ⅳ型7例。全部患者于真臼位置重建髋臼或小于2cm的运动中心上移进行髋关节置换。分别于术前，术后3、24个月对同一患者进行髋关节Harris评分，腰痛Oswestry评分。髋关节术前Harris评分（44±7）分，Oswestry评分平均（36±4）分。结果39例患者全部获得随访，髋部和腰部疼痛和功能均获得了显著改善，3个月后Harris评分（80±6）分（P〈0．01），24个月为（84±6）分（P〈0．05）。术后3个月Oswestry评分为（25±4）分（P〈0．01），24个月为（23±4）分（P〉0．05）。结论对合并下腰痛的单侧髋关节发育不良患者行全髋置换术后，下腰部疼痛和功能在3个月后得到显著改善，2年后仍保持并提高。

Objective To assess the effect of total hip replacement on lumbago in patients with unilaterally developmental hip dysplasia. Methods From January 2001 to January 2006, 39 adult patients with unilateral developmental hip dysplasia eoexiting lumbago were included. Among them, there were 32 females and 7 males, age from 38 years to 73 years. According to Crowe classification system, there were 4 in type Ⅰ , 20 in typeⅡ , 8 in type Ⅲ and 7 in type IV. They were performed total hip replacement. The Harris Hip Score and the Oswestry Disability Index were used to evaluate hip and spine symptoms in same patient before and 3, 24 months after operation. Results Thlrty-nlne patients were evaluated, both hip and spinal pain and function were significant improved. The mean Harris score increased from 44 to 84 （ P 〈 0. 01 ）. The mean Oswestry Scores dropped from 36 to 25 （ P 〈 0. 01 ）. Conclusion Spinal function and lumbago is improved after total hip replacement in patients with unilateral developmental hip dysplasia at 3 months, which is maintained and enhanced in 2 years.