Zweymuller系统全髋关节置换术治疗髋臼发育不良的中期疗效分析

Metaphase outcome of total hip arthroplasty with Zweymuller system in treating developmental dysplasia of the hip(DDH)

目的:评价Zweymuller螺旋臼结合髋臼加深技术治疗髋臼发育不良的中期疗效。方法:自1998年1月至2004年12月,采用Zweymuller系统进行全髋关节置换术治疗髋臼发育不良继发髋关节骨性关节炎患者56例62髋,男14例(15髋),女42例(47髋);平均年龄48.6岁(30～67岁)。术前所有患者均有髋关节疼痛和功能障碍。观察项目包括术后并发症、影像学及功能恢复情况。髋关节功能采用Harris评分标准进行评定。结果:56例获得随访,时间5～11年,平均6.5年。X线检查显示髋臼假体位于真臼位置,与周围骨床结合紧密,髋臼假体外展角35°～45°,股骨假体内、外翻3°以内,术后患肢短缩平均(0.5±0.2)cm。术后近期发生深静脉血栓20例,予溶栓治疗后好转。近期脱位1例,复位、制动3周后下地行走。4髋发生异位骨化、均为BrookⅡ型。无感染、神经损伤病例发生。术后Harris评分(87.4±3.5)分,与术前(43.2±6.7)分比较,差异有统计学意义(P<0.01)。结论:Zweymuller螺旋臼结合髋臼加深技术治疗髋臼发育不良继发髋关节骨性关节炎中期疗效优良。

Objective：To analyze the metaphase outcome of total hip arthroplasty with Zweymuller system and deepening acetabulum technique in treating DDH. Methods：From Jan.1998 to Dec.2004,56 patients （62 hips） with DDH （secondary osteoarthritis） were treated with total hip arthroplasty with Zweymuller system. There were 14 males（15 hips） and 42 females （47 hips） with an average age of 48.6 years,ranged from 30 to 67 years. All patients had pain of hip joint and functional disturbance before operation. Observation items included postoperative complications,imaging and function of hip joint. The function of hip joint was analyzed according to Harris scoring. Results：All patients were followed up from 5 to 11 years with an average of 6.5 years. X-rays showed that the acetabular cup was in the position of true acetabulum,which combined tightly with the peripheral bone,the abduction angle of the acetabular cup was from 35° to 45°,introversion and extroversion of the femoral prosthesis was within 3°,operated legs were shorter with a mean of（0.5±0.2） cm. The complications were as following：deep vein thrombosis in 20 cases,which were improved after thrombolysis;hip dislocation in 1 case,which was treated with reduction and immobilization for 3 weeks;ectopic ossification in 4 patients,all were BrookⅡtype;no found infection or nerve injury. The Harris scoring was 87.4±3.5 postoperative,which was significant higher than that preoperative（43.2±6.7）. Conclusion：The metaphase outcome of total hip arthroplasty with Zweymuller system and deepening acetabulum technique in treating DDH can obtain good result.