全髋关节置换术治疗先天性髋关节发育不良

Total hip replacement for congenital dysplasia of hip

目的:探讨全髋关节置换术治疗先天性髋关节发育不良患者继发骨性关节炎的临床效果。方法:对9例(11个髋)先天性髋关节发育不良继发骨关节炎的患者施行全髋关节置换术。本组随访11个月～9年,平均49个月。结果:根据MerleD'Aubigne评分标准,优7髋,良3髋,中1髋,优良率90.9%。无坐骨神经及股神经损伤患者。结论:全髋关节置换术是治疗先天性髋关节发育不良患者继发骨性关节炎的有效方法,注意肌力平衡,真臼安放生物性假体,细直柄假体应用骨水泥固定,调整前倾角是手术成功的关键。

Objective To evaluate the clinical efficacy of total hip replacement（THR） to treat with the hip osteoarthritis secondary to the congenital dysplasia of hip（CDH）.Method Eleven THR operations in 9 patients with hip osteoarthritis secondary to CDH were performed.The patients were followed up for 11 months to 9 years,mean 49 months.Results The efficacy of THR is graded according to the scoring standard of Merle D＇ Aubigne.Among all the hips,7 are excellent,3 are fine,1 is secondary.The fineness rate is 90.9%.There are no patients with ischiadic nerve and femoral nerve lesion after operations.Conclusion THR is an effective way to treat hip osteoarthritis secondary to CDH.To equilibrate the related muscular strength,implant biotic prosthesis in acetabulum,apply bone cement in placing femoral prosthesis and adjust the angle of anterior inclination of femoral prosthesis during operation are the most critical to this operation.