组配式假体全髋关节置换术重建双下肢等长

Total hip arthroplasty using modular necks prosthesis in leg length equality restoration

目的探讨股骨颈组配式假体对全髋关节置换术后双下肢等长恢复的作用及临床结果。方法本回顾性研究纳入2009年6月至2011年11月使用Neck-modular髋关节假体进行全髋关节置换术的患者共37例,所有患者对侧髋关节均存在不同原因的解剖及异常,使用常规髋关节假体难以重建双下肢等长。根据对侧下肢长度术中调整颈长,重建下肢长度。术后测量患者双侧棘踝线,测量分析影像学上肢体长度恢复情况,评估患者主观感觉及术后Harris髋关节评分。结果所有37例患者术后双侧棘踝线测量及影像学上测量双侧下肢长度偏差均≤1cm,术后12周Harris评分平均84分(63～93),所有患者髋关节均能获得良好的活动度,无一例出现股骨髋臼撞击症(FAI)和脱位。术后平均随访14.3个月(3～32个月),Harris评分平均94分(76～98)。结论使用股骨颈组配式髋关节假体可恢复双下肢等长,并获得良好的关节活动度,减少并发症,临床结果满意。

Objective To assess the effect and outcome of total hip arthroplasty （THA） with modular femoral neck prosthesis system. Methods From June 2009 to November 20ll, 37 patients of THA with modular femoral neck implant were retrospectively studied. There were varielies of anatomic factors and abnormities in heterolateral hips of all cases, which might lead to leg length discrepancy using conventional hip implant system. Neck length was determined according to heterolateral leg length to restore leg-length equality. The spines ankle line, postoperative radiograph, patient＇s subjective sensation and Harris hip score were all measured. Results All patients＇ leg-length discrepancy was within l era by measuring the spines-ankle line and postoperative radiograph. Mean Harris hip score were 84 （63 -93） at 12 weeks post-operatively and 94 （76 -98 ） at the last follow-up （range： 3 to 32 months, mean 14. 3 months）. All patients got excellent range of movement （ROM）. Femora acetabular impingement （FAI） or dislocation did not occure. Conclusions Restoration of leg-length could be achieved with modular femoral neck prosthesis and the patients could have excellent ROM. THA with modular femoral neck prosthesis could reduce complications and give satisfactry clinical results.