生物型假体关节置换术治疗髋关节发育不良继发骨性关节炎

Treatment the Osteoarthritis Secondary to Acetabular Dysplasia with Cementless Prosthesis

目的评估采用生物型假体行全髋关节置换术（THR）治疗髋关节发育不良（DDH）继发骨性关节炎的临床效果。方法自2001年1月～2006年3月，采用生物型假体行THR治疗44例（49髋）成人DDH继发骨性关节炎患者，根据Crowe分型：Ⅰ型10例（12髋），Ⅱ型19例（21髋），Ⅲ型11例（12髋），Ⅳ型4例（4髋）。结果随访2～8年（平均4年1个月），Harris评分由术前43．52分恢复到术后90．32分。假体均位于解剖位置，尚未见术后感染及松动发生，术前患者双下肢长度差为1～5am，术后为0～1cm，41例46髋疼痛完全消失，3例3髋有轻度疼痛伴有轻度跛行，但能够生活自理且恢复正常工作，其余患者均步态正常。术前2例伴有腰部疼痛．均在术后1．5年消失。结论生物型假体行THR治疗成人DDH继发骨性关节炎，能够取得较好的临床效果。

Objective To evaluate the results of treatment of the osteoarthritis secondary to acetabular dysplasia with cemenfless prosthesis. Methods Forty-four cases （49 hips） of severe osteoarthritis secondary to development dysplasia of hip （DDH） underwent total hip replacement （THR） with cementless prosthesis from January 2001 to March 2006. According to Crowe classification,there were type Ⅰ in 12 hips,type Ⅱ in 21 hips,type Ⅲin 12 hips,and type Ⅳ in 4 hips. Results The mean follow up period was 49 months （range from 24 months to 96 months）.Harris scores improved from 43.52 to 90.32.All prosthesis located in the anatomical position. There were no signs of infection or aseptic loosening. The difference of two legs length diminished after operation and the pain vanished in 41 patients （46 hips）. Three patients （3 hips） had gentle pain with light limp, but they had normal life.Two patients had low back pain and the symptom disappeared after 1.5 yeats.Conclusion The treatment of the osteoarthritis secondary to acetabular dysplasia with cemendess prosthesis has a good clinical result.