先天性髋臼发育不良继发骨性关节炎的外科治疗

Primary Zweymuller total hip arthroplasty for osteoarthritis secondary to congenital acetabular dysplasia

目的 探讨Zweymuller型人工全髋关节假体置换治疗先天性髋臼发育不良继发髋关节骨性关节炎的有效性。 方法 应用Zweymuller型人工全髋关节假体 ,对 2 9例 32个先天性髋臼发育不良继发髋关节骨性关节炎患者行全髋关节置换 (THR)。患者全部为女性 ,单侧 2 6例 ,双侧 3例。Perner分型Ⅰ度 17例 ,19个髋 ,Ⅱ度 7例 ,7个髋 ,Ⅲ度 4例 ,5个髋 ,Ⅳ度 1例 ,1个髋。平均随访 2 7 5个月 ,术前Harris评分最高 5 9分 ,最低 2 5分 ,平均 44 5分。 结果 所有患者髋关节疼痛完全消失 ,关节活动度增加 ,Harris评分最高 97分 ,最低 6 3分 ,平均 85分。 结论 特殊设计的Zweymuller型人工全髋关节假体置换初期稳定 ,手术不需大块植骨和骨水泥 。

Objective To evaluate the effectiveness of Zweymuller prothesis in replacing osteoarthritis secondary to congenital dysplasia of the hip. Methods From January 1996 to June 2000, Zweymuller prothesis was used to reconstruct 32 hips in 29 patients with congenital acetabular dysplasia(3 bilateral cases). All patients were female. According to the classification of Perner, 19 hips belonged to type Ⅰ, 7 type Ⅱ, 5 type Ⅲ, and 1 type Ⅳ. The mean follow up period was 27 5 months (6-53 months). The preoperative Harris hip score ranged from 25 to 59(average 44 5). Results The pain was completely relieved, and the Harris hip score ranged from 63 to 97(average 85). Conclusion We consider that the Zweymuller total hip arthroplasty provides stable fixation of the cup in the presence of moderate acetabular dysplasia without structural bone grafting or cementing.