全髋关节置换术治疗化脓性髋关节炎后遗关节畸形的临床研究

Clinical research of total hip arthroplasty for hip pyogenic infection sequelae

目的探讨人工全髋关节置换术（THA）治疗化脓性髋关节炎后遗关节畸形的近期临床疗效。方法 21例（22髋）化脓性髋关节炎后遗关节畸形行THA治疗。比较术前与末次随访时髋关节功能Harris评分,并随访观察假体稳定性。结果所有患者均获得平均45（24-58）个月随访。手术切口均一期愈合,无关节脱位、深静脉血栓形成、坐骨神经损伤或感染复发等并发症。所有患者均未出现〉2 mm的透亮带,无假体松动。临床症状及髋关节功能明显改善,末次随访时髋关节功能Harris评分平均89.5（73-97）分,较术前平均45.3（25-62）分明显提高,差异有统计学意义（t=13.642,P〈0.001）。结论 THA治疗化脓性髋关节炎后遗关节畸形的近期疗效良好。

Objective To analyze the early clinical curative effect of total hip arthroplasty for hip pyogenic infection sequelae. Methods Total hip arthroplasty was performed in 22 hips of 21 patients who had hip sequelae secondary to hip pyogenic infection. The clinical effect was measured with Harris hip score preoperatively and at the last follow-up, and the prosthesis stability was observed. Results The average follow-up period was 45 months（range, 24-58 months）. There were no cases of dislocation, deep vein thrombosis, sciatic nerve palsy, or postoperative re-infection. Until the last follow-up, no continuous radiolucent line wider than 2 mm or prosthesis loosening occurred. The median Harris hip score improved from 45.3（range, 25-62） preoperatively to 89.5（range, 73-97） at the last follow-up, which was statistically significantly different（P〈 0.05）.Conclusion Total hip arthroplasty has good early clinical curative effect for the treatment of hip pyogenic infection sequelae.