全髋关节置换治疗强直性脊柱炎髋关节强直的临床体会

Clinical Comprehension of Total Hip Replacement Treating Hip Joint Ankylosis in Ankylosing Spondylitis

目的:观察全髋关节置换治疗强直性脊柱炎髋关节强直的临床疗效。方法:对43例(59髋)强直性脊柱炎患者行人工全髋关常置换术,并进行了平均4～5年的随仿。临床随访根据Harris评分系统进行评分,异位骨化评定采用Brooker分级法;髋臼侧假体采用DeLee和Charnley方法进行影像学观察评定。结果:至最后一次随访,术后髋关节屈曲活动度改善最为明显,髋关节前屈达到(83.59±9.15)°,髋关节后伸达到(18.43±6.46)°,Harris评分(87.36±5.39)分,其中优23例,良12例,优良率为81.39%,置换后5髋(8.47%)发生异位骨化。其余病例无感染、假体松动、折断、脱位移位发生。结论:全髋关节置换是治疗强直性脊柱炎髋关节强直的有效手段,可以缓解关节疼痛,恢复关节功能,改善患者生活质量。

Objective：To observe the clinical effectiveness of total hip replacement on hip joint ankylosis in the patients with ankylosing spondylitis.Methods：43 patients（59 hips） with ankylosing spondylitis received artificial total hips replacement and 4～5 years follow-up on average.Clinical follow-up was scored according to Harris scor.and Urooker grading was used to conduct ectopic ossification evaluation;DeLee and Charnley methods were adopted to perform imaging observation on acetabulum lateral prosthesis.Results：Postoperative flexible activity of hip joint improved evidently with antefiexio as（83.59±9.15）°and post-stretch as （18.43±6.46）°until the last follow-up.Harris score was 87.36±5.39 including 23 cases as excellent score,12 cases as fine score and fineness rate was 81.39%.Besides,five hips suffered from ectopic ossification after replacement.The remaining patients were free from infection,prosthetic loosening,fracture,dislocation and displacement.Conclusions：Total hip replacement serving as an effective way to treat ankylosing spondylitis can relieve arthralgia,regain joint function and improve quality of life.