非短缩截骨全髋关节置换治疗高位髋关节发育不良

Total Hip Replacement without Femoral Shortening Osteotomy for High Dislocated Hips

目的：评估高位髋关节发育不良患者非短缩截骨全髋关节置换（THR）的中长期临床疗效。方法：回顾分析我院2005年9月-2011年6月高位髋关节发育不良进行非短缩截骨的THR 34例（36髋）。患者平均年龄45岁（35~62岁）,通过对临床和影像学资料进行分析,评估其临床疗效。结果：所有患者均获得随访,平均随访40个月（24~72月）。平均Harris髋关节评分从术前的50分（30~70分）改善到末次随访的88分（80~96分）。患肢平均延长38mm（30~50mm）,双下肢长度差异从术前的40mm（15~60mm）改善到术后6.5mm（2~12mm）。未发生脱位及感染,未出现假体松动。结论：非短缩截骨全髋关节置换术治疗高位髋关节发育不良患者安全有效,中长期随访效果好。

Objective：To investigate the clinical outcomes of the total hip replacement（THR）without femoral shortening osteotomy for serious developmental dysplasia of the hip（DDH）.Methods：Between September 2005 and June 2011,34 patients of DDH（36hips）with Crowe type III,IV were treated with THR without femoral shortening osteotomy.The mean age was 45years（35to 62）.The clinical and imaging data were analyzed for assessing the clinical effect.Results：All patients were followed up and the mean period was 40 months（24to 72）.The mean Harris hip score improved from 50points（30to 70）pre-operatively to 88points（80to 96）at the last follow-up.The mean leg lengthening was 38mm（30to 50）and the mean leg-length discrepancy dropped from 40mm（15to 60）pre-operatively to 6.5mm（2to 12）postoperatively.No dislocations or infections were encountered,and no loosening of the implant was observed.Conclusion：THR without femoral shortening osteotomy was proved to be safe and effective.