双锥面螺旋臼假体置换治疗类风湿性髋关节炎24例

Bicon-threaded cup for treating hip rheumatoid arthritis in 24 cases

目的：观察Zweymüller双锥面螺旋臼在类风湿性髋关节炎全髋置换中的临床应用效果。方法：回顾性分析山东大学附属省立医院关节外科收治的类风湿性关节炎患者24例（39髋）,男8例（14髋）,女性16例（25髋）;年龄32-64岁,平均49.2岁;病程4-15年,平均8.5年。所有病例均采用Bicon-plus Zweymüller螺旋臼假体进行置换,Harris评分评估髋关节功能,观察伤口愈合情况及围置换期并发症;X射线平片观察髋臼假体位置。结果：24例患者均获得随访,随访时间14-62个月,平均37.5个月。所有患者切口均Ⅰ期愈合,2例出现小腿腓肠肌静脉血栓,非手术治疗后痊愈。所有患者髋关节疼痛消失,髋臼稳定,关节活动度增加。双髋关节正位片及术侧髋关节侧位片显示,假体与骨组织整合良好,假体周围无透亮线,髋臼假体无松动,股骨假体无下沉。Harris评分由置换前的平均33.5（17-46）分提高到置换后3个月的平均86.5（79-96）分。未出现脱位、骨折、神经损伤等并发症。结论：Zweymüller双锥面螺旋臼适用于类风湿性髋关节炎全髋置换者,初期随访效果满意。

OBJECTIVE： To observe the clinical effect of Zweymüller bicon-threaded cup in total hip arthroplasty for treating hip rheumatoid arthritis. METHODS： A retrospective analysis was performed on 24 cases （39 hips） of rheumatoid arthritis selected at the Department of Joint surgery of the Affiliated Provincial Hospital of Shandong University, including 8 males （14 hips） and 16 females （25 hips）, aged from 32 to 64 years （average 49.2 years old）, course of disease being from 4 to 15 years （average 8.5 years）. All the cases were operated with Bicon-plus Zweymüller threaded cup, and the function of hips were evaluated with Harris hip score system, the state of wound healing and perioperativ complications were examined, and the position of acetabulum prosthesis was observed by X-ray film. RESULTS： All patients were followed up, and the follow-up time ranged from 14 to 62 months （average 37.5 months）. They were all obtained first-stage wound healing, and two cases of gastrocnemius vein thrombus were found among them, occurred by non-operation. All patients were free from pain with stable fixation and mobility increasing. The process of osseo integration being well, the radiolucent line and radiographic loosening of acetabulum prosthesis and sedimentation of stem were not found on antero-posterior pelvis-radiograph and lateral radiograph of ipsilateral hip. The Harris hip score increased from preoperative 33.5 points （17-46 points） to postoperative 86.5 points （79-96 points） at 3 months. There were no complication appeared such as dislocation, fracture and nerve injury. CONCLUSION： Zweymüller threaded cup used in total hip arthroplasty is proved to be suitable to the patients with hip rheumatoid arthritis.