晚期强直性脊柱炎髋、膝、踝关节非功能位骨性强直的功能重建

Reconstruction of hip,knee,and ankle bony fused in non functional position of ankylosing spondylitis patients

目的 探讨晚期强直性脊柱炎髋、膝、踝关节均在非功能位骨性强直患者的关节功能重建。 方法 1996年 1月～ 1997年 5月采用一次麻醉下同侧髋、膝、踝关节同时置换术 ,对 2例晚期强直性脊柱炎 3侧髋、膝、踝关节骨性融合在非功能位的患者进行关节功能重建 ;分别随访 2 2个月和36个月 ,观察关节活动度恢复情况 ,进行关节功能评分。 结果 2例患者膝关节术后平均活动度为76 7° ,HSS评分平均提高 45分 ;髋关节术后平均总活动度为 145 7° ,Harris评分提高 37 7分。随访期间患者髋、膝、踝关节活动度基本正常 ,生活自理。 结论 对于晚期强直性脊柱炎下肢多关节骨性强直在非功能位的患者 ,同侧下肢髋、膝。

Objective [WT5”BZ]To evaluate the reconstruction of hip,knee and ankle joints with bony fusion at non functional positions for patients with severe late stage ankylosing spondylitis (AS). Methods From January 1996 to May 1997,simultaneous ipsilateral total hip,knee and ankle replacement was performed under single anesthesia on 2 patients (3 sides) with multiple joint deformity including bony fusion at non functional positions.They were followed for 29 months on average. Results Satisfactory range of motion and function were observed. HSS knee score on average was improved by 45 points and Harris hip score by 37 7 points.There were no wound healing problems or late infection.No aseptic loosening was found. Conclusions Simultaneous ipsilateral total hip,knee and ankle replacement not only reduced cost for hospitalization,but also facilitated early rehabilitation.To our knowledge,this is the first report on this type of surgery,named ipsilateral tri arthroplasty.