全髋置换术治疗髋关节发育不良伴骨关节炎34例报告

Total hip arthroplasty for adult developmental dysplasia of the hip combined with osteoarthritis:34 cases report

[目的]研究全髋置换术治疗髋关节发育不良伴骨关节炎的方法及疗效。[方法]自2004年10月～2009年10月,对34例(41髋)髋关节发育不良伴骨关节炎的成年患者进行了人工全髋关节置换术,其中女性27例32髋,男性7例9髋,平均年龄5 7岁(35～76岁)。按Crowe分型,Ⅰ型16例19髋,Ⅱ型12例14髋,Ⅲ型6例8髋,术前平均Harris评分(43.5±10.5)分。[结果]手术出血量平均350 ml(200～600 ml),输血量平均230 ml(0～600ml),引流量平均200 ml(110～450 ml),手术时间平均100 min(85～130 min),术后平均Harris评分(94.5±3.2)分,较术前有明显提高(P<0.05),优良率达95%。术后平均随访4.8年(2～7年),未发现感染、无菌性松动、假体下沉、异位骨化等并发症。[结论]对于髋关节发育不良伴骨关节炎的成年患者,全髋置换术是一种较好的治疗方法。

[ Objective] To evaluate the methods and efficacy of total hip arthroplasty （THA） in treating adult develop- mental dysplasia of the hip （DDH） combined with osteoarthritis. [ Methods] From October 2006 to October 2009, 41 hips in 34 cases with osteoarthritis secondary to DDH underwent THA. There were 27 females and 7 males, aged from 35 to 76 years, average 57 years. According to Crowe classification, there were type I in 19 hips, type II in 14 hips and type III in 8 hips. The preoperative average Harris score was （43.5 ± 10. 5 ） . [ Results ] The mean volume of bleeding, blood transfusion and drain- age after operation were 350 （200 ±600） ml, 230 （0 -600） ml and 200 （110 ±450） ml respectively. The average opera- tion time was 100 min （85 ± 130 min） . The postoperative average Harris score increased to （94. 5 ±3.2 ）, much better than that preoperatively （P 〈0.05 ） . The rate of clinic results of good or excellent was 96%. The mean follow - up period was 4.8 years （ranged, 2 - 7 years） . No complications such as infection, aseptic loosening, prosthesis subsidence, ectopic ossifica- tion and neurovascular injury were found. [ Conclusion] THA is an effective and safe method in treating adult DDH combined with osteoarthritis.