特殊类型全髋关节置换术的疗效分析

Curative Effect of Total Hip Arthroplasty on Patients with Specific Problems of Hip Joints

目的探讨成人髋臼发育不良致股骨头坏死和股骨上端骨肿瘤患者行全髋关节置换术的疗效。方法对10例16侧成人髋臼发育不良并股骨头坏死者(双侧6例,单侧4例)行全髋关节置换术,另对8例股骨近端肿瘤者(3例复发性骨巨细胞瘤,5例骨转移瘤)作瘤段切除全髋关节置换术。结果术后所有患者均获随访。股骨头坏死16侧Harris评分由术前的平均36.6分恢复到术后的89分;8例股骨近端肿瘤经假体置换后,Harris评分平均为93.5分。结论全髋关节置换术治疗成人髋臼发育不良致股骨头坏死及股骨近端肿瘤疗效确切,用以治疗股骨近端肿瘤具有肿瘤切除彻底、负重早、功能恢复快及生活质量高的优点。

Objective To evaluate the effect of total hip arthroplasty on patients with femoral head necrosis due to developmental dysplasia of the hip （DDH） and proximal femoral tumor. Methods Total hip arthroplasty （THA） was performed in 10 patients with femoral head necrosis due to DDH （6 patients were bilateral and 4 patients were unilateral）; THA after the tumor resection was performed in 8 patients with proximal femoral tumors （3 patients were recurrent giant cell tumor and 5 patients were bone metastatic tumor）.Results All the patients were followed up.For the patients with DDH, the average Harris scores after the operation were 89 points which was higher than 36.6 points before the operation. And the average Harris scores after the operation were 93.5 points for the 8 patients with proximal femoral tumor.Conclusion THA is effective for the proximal femoral tumor and the femoral head necrosis due to DDH. And the treatment for the proximal femoral tumor has several advantages including complete resection of the tumor, early weight loading, quick function recovery and high quality of the life.