髋关节骨性强直或融合后的全髋关节置换术

Total hip replacement for ankylosed or fused hip joint

目的 探讨髋关节骨性强直或融合后行全髋关节置换术的可行性。方法 对 10例髋关节骨性强直或融合患者行全髋关节置换术的临床疗效及手术相关问题进行分析。结果 随访 6～ 30个月 (平均 18个月 ) ,10例 12个髋关节活动度术前为 0° ,术后总的活动度平均 16 3° ,屈髋平均 89°;Har ris评分术前平均 15 6分 ,术后平均 89分。术后髋痛消失 ,膝痛、下腰痛明显改善 ,步态基本恢复正常 ,8例重返工作岗位。结论 髋关节骨性强直或融合后如果发生严重的下腰痛、对侧髋关节、同侧膝关节疼痛或髋关节融合在非功能位上 ,髋关节周围软组织条件好 ,外展肌基本正常 。

Objective To investigate the possibility of total hip replacement for ankylosed hip joint. Methods Retrospective analysis of the operative effect and related problems of the total hip replacement for ankylosed hip joint. Results Through follow up for 6 to 30 months (18 months on average), the average range of motion of hip joint and of flexion was 163°and 89°,respectively. The postoperative Harris Score was 89 versus the preoperative Harris Score of 15 6. The pain of the hip was relieved almost completely and 8 patients restored to the previous working position. Conclusion The indications of total hip replacement for ankylosed hip joint can be summarized as disabling pain of the low back, contralateral hip joint and ipsilateral knee joint; dysfunctional position of ankylosis hip joint; The condition of soft tissue around the hip joint is good, and the function of abductor muscles is normal.