人工全髋关节置换术治疗强直性脊柱炎髋关节病变

Total hip arthroplasty for ankylosing spondylitis:an intermediate-term follow-up study of seventeen cases

目的分析人工全髋关节置换术治疗强直性脊柱炎患者的中期疗效。方法对17例(26髋)强直性脊柱炎患者行人工全髋关节置换术,随访时间平均3.8(2～7)年。临床随访根据Harris评分系统进行评分,并进行X线分析。结果Harris评分由术前的平均27(4～47)分提高到了术后的平均81.3(57～90)分,优良率88.5%;X线片未见假体松动、脱位或折断;异位骨化发生率15.3%(4髋)。结论人工全髋关节置换术治疗强直性脊柱炎患者髋关节病变,近、中期疗效较肯定。

Objective To evaluate the intermediate-term efficacy of total hip arthroplasty （THA） in the management of ankylosing spondylitis （AS）. Methods THA was performed in 26 hips of 17 AS patients, and the patients were followed up for average 3.8 （ ranging 2 to 7 ） years. The clinical outcomes were evaluated by the Harris hip scoring system, radiographic analysis by Gruen＇ s zonal method for the stem and the zonal classification of Delee and Charnley for the cup implants. Results The average Harris hip score improved from preoperative 27 （ ranging 4 to 47） to 81.3 （ ranging 57 to 90） at the final postoperative evaluation. The overall clinical outcomes were rated as good or excellent in 88.5%. There were no signs of loosening, dislocation or fracture of the prosthesis. According to the system of Brooker, the incidence of heterotopic ossification was 15.3% （4 hips）. Conclusion Our intermediate-term follow-up indicates THA is an effective method for AS patients to reconstruct the function of hip joint.