成人发育性髋关节结构不良继发骨性关节炎S-ROM假体全髋关节置换治疗:57例63髋随访分析

S-ROM prosthesis total hip replacement for osteoarthritis secondary to developmental dysplasia of hip: Follow-up analysis of 57 cases with 63 hips

背景:S-ROM假体可以进行多种组合,使医生可以根据不同的患者制定最佳的全髋关节置换方案。目的:观察使用S-ROM假体全髋关节置换治疗成人发育性髋关节结构不良继发骨性关节炎的近期效果。方法:选择解放军总医院骨科2002-11/2007-02收治的成人发育性髋关节结构不良继发骨性关节炎患者57例(63髋),均应用S-ROM型假体进行初次全髋关节置换,进行Harris评分比较置换前后髋关节功能,拍摄X射线片随访假体松动、下沉、断裂、骨质吸收和骨折等情况。结果与结论:置换后随访6个月～5年,平均3.5年,1例患者出现一过性腓总神经麻痹,4个月后恢复。1例患者出现髋脱位,予以手法复位牵引,肌力恢复后不再脱位。其余患者无感染及血管神经损伤发生。Harris评分为70.20～92.10分,平均88.30分,与置换前比较改善明显(P<0.05)。X射线片检查未发现假体松动、下沉、断裂、骨质吸收和骨折等现象。结果提示,S-ROM假体全髋关节置换治疗成人发育性髋关节结构不良继发骨性关节炎的近期效果满意。

BACKGROUND： The optimal total hip replacement can be prepared by assembling S-ROM prosthesis individually. OBJECTIVE： To evaluate the short-time effect of S-ROM prosthesis total hip replacement for osteoarthritis secondary to developmental dysplasia of hip. METHODS： Totally 57 adult patients （63 hips） with osteoarthritis secondary to developmental dysplasia of hip treated by S-ROM prosthesis for primary total hip arthroplasty from November 2002 to February 2007 were selected. The preoperative and postoperative Harris score were compared. The prosthesis loosening, fracture and subsidence, bone absorption and fracture were followed-up with radiographic results. RESULTS AND CONCLUSION： All patients were followed up from 6 months to 5 years, mean 3.5 years. One patient suffered temporary common peroneal nerve palsy, and recovered after 4 months. One patient suffered hip dislocation, and recovered after manipulative reduction and traction. There were no complications in the rest patients. The Harris hip score was 70.20-92.10, mean 88.30, which was obvious increased than that of before operation （P 0.05）. No loosening, fracture and subsidence of prosthesis, bone absorption or fracture was observed. The results demonstrated that S-ROM prosthesis total hip replacement can receive an excellent short-time effect in treating osteoarthritis secondary to developmental dysplasia of hip.