全髋关节置换治疗强直性脊柱炎11例

Total hip arthroplasty for the treatment of ankylosing spondylitis in 11 cases

2000-08/2006-03江苏省兴化市人民医院骨科对11例(19髋)强直性脊柱炎者行人工全髋置换,并进行了22个月～7年的随访。患者均为男性,平均年龄38岁,病程4～31年,单侧3例,双侧8例。手术切口采用改良髋关节前外侧与外侧联合切口,假体使用均为生物型假体(19髋)。以X射线结果评价置换后髋关节假体有无脱位,松动等;以Harris评分进行置换后临床效果评定。至末次随访,Harris评分由置换前平均34.2分提高到85.5分,髋关节活动度明显改善,除1例髋关节置换后出现早期脱位外,X射线检查未见假体松动移位迹象,异位骨化发生率为10.5%(2髋)。提示人工全髋关节置换治疗强直性脊柱炎晚期髋关节病变可以明显缓解髋关节疼痛,改善关节功能,提高生活质量。

From August 2000 to March 2006, 11 male patients （ 19 hips, average age of 38 years） with ankylosing spondilitis who underwent total hip arthroplasty were analyzed retrospectively with a follow-up period of 22 months to 7 years. The disease course was 4-31 years. Three patients had unilateral surgery, and 8 had bilateral one. Modified anterior lateral hip and lateral incision was used. The Harris grade system and X- ray examination were used to evaluate the curative effects. At the final follow-up, Harris hip score was improved from 34.2 to 85.5, and the postoperative movement range was significantly improved. Except for one hip dislocated at the early time after operation, there was no sign of prosthesis loosening. The incidence of heterotopic ossification was 10.5 % （2 hips）. Total hip arthroplasty can greatly relieve the pain of the patients, reconstruct the function of hip joint and improve the quality of life for patient with ankylosing spondilitis.