应用组配式S-ROM假体行初次全髋关节置换术治疗严重髋关节发育不良

Primary total hip arthroplasty using the modular S-ROM prosthesis for the treatment of severe developmental dysplasia of the hip

[目的]探讨应用非骨水泥型组配式S-ROM假体行初次全髋关节置换术治疗严重髋关节发育不良的近期疗效。[方法]对18例（19髋）严重髋关节发育不良患者应用S-ROM假体行初次全髋关节置换术。其中男性6例,女性12例,平均年龄32岁。按Crowe分型,CroweⅢ型11例11髋,CroweⅣ型7例8髋。手术采用在真臼位置磨锉加深重建髋臼,股骨侧选用S-ROM组配式假体,复位困难者行转子下截骨。术前和术后随访时应用Harris髋关节评分（Harris hip score,HHS）和影像学检查对髋关节功能进行评估。[结果]术中1例股骨近端裂缝骨折,用双股钢丝环扎固定。术后有2例出现坐骨神经牵拉症状,术后3个月内完全恢复。所有患者均得到有效随访,有1例患者大转子上方发生异位骨化,但不影响关节活动度,未发现感染、骨质溶解、假体松动、脱位等并发症。平均随访2.8年（6个月-5年）。HHS评分由术前平均38.4分增加到末次随访时的85.2分。[结论]S-ROM假体是治疗严重髋关节发育不良的理想选择,近期效果良好。

[Objective]To research short-term results of primary total hip arthroplasty using the cementless modular S-ROM prosthesis for the treatment of severe developmental dysplasia of the hip.[Method]Eighten patients（19 hips） with severe developmental dysplasia of the hip underwent primary total hip arthroplasty using the S-ROM prosthesis.Of the patients,6 were male and 12 were female.The average age was 32 years.According to the Crowe classification system,there were 11 hips in type Ⅲ and 8 hips in type Ⅳ.The acetabulums were deepened at the level of the true acetabulum.The S-ROM modular stems were used on the femoral side.Subtrochanteric shortening osteotomy was performed when it was difficult to reset.The Harris hip score（HHS） and radiography were used to evaluate the hip function preoperatively and at the follow-up.[Result]One proximal femur tissure fracture occurred,and was bundled up with circle wire.There were 2 postoperative sciatic nerve irritation,which disappeared completely within 3 months.All patients were available for follow-up.There was one heterotopic ossification above greater trochanter.But the mobility of the hip was normal.There was no loosening or infection during the follow-up.Average follow-up period was（2.8） years（range,6 months-5 years）.The HHS increased from 38.4 preoperatively to 85.2 at the time of final follow-up.[Conclusion]S-ROM is a perfect choice for the teatment of severe developmental dysplasia of the hip.Short-time clinical results were excellent.