全髋关节置换治疗髋臼骨折术后继发创伤性关节炎

Total hip arthroplasty for posttraumatic arthritis after operative treatment of acetabular fractures

目的探讨全髋关节置换术(THA)治疗髋臼骨折术后继发创伤性关节炎的方法和临床疗效。方法采用THA治疗23例髋臼骨折术后继发创伤性关节炎患者。结果患者均获随访,时间6～66个月。Harris评分由术前的(45.5±13.6)分提高到末次随访时的(88.5±7.8)分,差异有统计学意义(P<0.01),其中优16例,良4例,可3例。2例非骨水泥型臼杯和1例骨水泥型臼杯出现非连续性X线透亮带,但无假体下沉或移位表现。患者均无术后感染、关节脱位、严重的异位骨化及血管、神经损伤。末次随访时无翻修患者。结论髋臼骨折术后继发创伤性关节炎通过细致的术前计划、充足的植骨修复、正确选择假体类型、针对性个性化的治疗,THA能够取得良好的临床疗效。

Objective To investigate the clinical results in total hip arthroplasty（THA） for posttraumatic arthritis secondary to open reduction and internal fixation（ORIF） of acetabular fractures.Methods 23 patients were performed THA in our department for posttraumatic arthritis secondary to acetabular fractures.Results All patients were followed up for 6～66 months.Harris hip score increased from（45.5±13.6） points preoperatively to（88.5±7.8） points at the latest follow-up.There were significant statistical differences between preoperative and postoperative Harris score（P0.01）,the results was excellent in 16 cases,good in 4,fair in 3.A partial radiolucent line was seen in two cementless acetabular cup and one cemented cup without signs of prosthesis subsidence or migration in THA.The results revealed that there were no postoperative infections,hip dislocation,significant heterotopic ossification,blood vessel or nerve injury in the follow-ups.Furthermore there was no patient with cup or stem revised.Conclusions Total hip arthroplasty can achieve a fine clinical result by careful surgical plans,sufficient bone grafts and correct choice different type prostheses.