非骨水泥型全髋关节置换术治疗强直性脊柱炎髋关节病变

Cementless total hip arthroplasty in ankylosing spondylitis

目的探讨非骨水泥全髋关节置换术治疗强直性脊柱炎髋关节病变的手术策略和临床疗效。方法对38例(58髋)强直性脊柱炎累及髋关节的患者行非骨水泥型全髋关节置换术,平均随访时间为26.6(20-45)个月。对手术前后关节疼痛、活动度、关节功能改善进行对比研究,术后关节功能根据Harris评分进行评价。结果所有患者术后临床症状及髋关节功能均得到明显改善。屈曲活动度由术前平均22.9°,改善为术后平均83.3°;总活动度由术前平均36.5°,改善为术后139.3°。Harris评分由术前平均38.7分,改善为术后平均87.2分。X线分析未见假体松动、脱位。结论非骨水泥全髋关节置换术是治疗强直性脊柱炎髋关节病变的有效方法。

Objective To study the clinical efficacy and strategy of cementless total hip arthroplasty（THA） in patients with ankylosing spondylitis（AS）. Methods THA was performed for 58 hip-joint lesions due to AS in 38 patients. The patients were followed up for 26.6 months（range 20-45 months）. Pain, motion and function of hip-joints were compared before and after operation. The function of hip-joint was evaluated with the Harris scoring system. Results The symptoms and function of hip-joint were significantly improved in all patients after operation. The flexion, motion and score of hip-joint before operation were increased from 22.9° to 83.3° , 36.5° to 139.3° , and from 38.7 to 87.2 after operation, respectively. X-ray examination showed no looseness and dislocation of the prosthesis. Conclusion Cementless THA is a valid procedure for hio-ioint lesions due to AS.