僵直性髋关节全髋关节置换术的近期疗效分析

Short-term clinical outcome of total hip arthroplasty in patients with ankylosing hips

目的探讨僵直性髋关节行人工全髋关节置换的手术方法和近期疗效。方法选择2008年1月至2012年1月确诊髋关节融合的患者11例,其中髋关节伸直位强直6例,屈曲位强直5例,屈曲畸形30~60°。髋关节Harrsi评分16.0~38.0分,平均26.0分。均采用髋关节前外侧入路行人工全髋关节置换术,采用Harrsi评分进行术后临床评定,X线检查观察假体周围有无松动及异位骨化,评价本组患者的治疗效果。结果本组患者术后均无切口感染、神经血管损伤、假体脱位、松动和下肢深静脉血栓形成。屈曲畸形得到完全矫正,术后髋关节屈伸活动度0.0~100.0°,平均75.5°;内收10.0~15.0°,平均12.0°;外展20.0~40.0°,平均25.0°。随访观察6~24个月（平均9个月）,未出现假体脱位、松动。术后Harrsi评分59.0~90.0分,平均76.4分。结论人工全髋关节置换术是治疗僵直性髋关节的有效方法,可明显增加髋关节活动度,矫正髋关节畸形,改善髋关节的功能,提高患者的生活质量。

Objective To study the surgical methods of total hip arthroplasty（THA） in patients with ankylosing of the hip and evaluate its curative effect after total hip arthroplasty.Methods Eleven patients had taken total hip arthroplasty for ankylosing of the hip from January,2008 to January,2012.Six cases had freezing hip in the extension position,and 5 cases had flexion deformity with 30-60°.The pre-operation Harris hip score were16.0 to 38.0 and the average scores were 26.0.All patients had total hip arthroplasty from anterolateral approach.Eight cases were followed-up for 6-24 months,the average follow-up period was 9 months.Post-operation Harris score was measured,and X-ray was taken to find out its curative effect after total hip arthroplasty.Results Incision infection,DVT and injury of nerve and vessels were not found.There were no dislocation,aseptic loosening or fracture of prosthesis neither.Flexion deformity was completely corrected.The range of flexion and extension extending was 0-90°（mean 75.5°）,while the adduction range was 10-15°（mean 12.0°）,and the abduction range was 20-40°（mean 26.7°）。 The post-operation Harris score was 59 to 90 and the average score was 76.4.Conclusion Total hip arthroplasty is effective for the treatment of the patients with ankylosing hip joint.THA can significantly correct the deformity of hip and improve its function.The short-term outcome of these cases is encouraging.