髋臼缺损畸形的人工髋关节置换手术疗效分析

Analysis of the Effect of Artificial Hip Replacement in the Treatment of Acetabular Defect

目的探讨髋臼缺损畸形的人工全髋关节置换术的处理方法。方法选取我院收治存在髋臼缺损畸形患者30例,包括髋臼发育不良13例、髋臼创伤骨折后畸形愈合5例、类风湿性关节炎6例,强直性脊柱炎髋关节病变6例,均行全髋关节置换术,采取髋臼加深、双锥面螺旋型髋臼、自体结构性植骨及钛网加植骨等多种方法行真臼重建,全部病例术前行CT三维重建,评分标准采用Harris评分。结果随访6～36个月,随访期间未发生人工髋关节假体松动、周围骨折等。Harris评分术前（36±6.5）,术后（93±5.2）。结论对于髋臼缺损畸形的全髋关节置换术中,通过髋臼加深、Zweymulle双锥面螺旋型髋臼、颗粒压配植骨、自体结构性植骨及钛网加植骨等多种方法能很好的重建髋臼,恢复良好的稳定性和Harris评分,能取得很好的疗效。

Objective To study the acetabulum defect deformity treatment methods of artificial total hip replacement.Methods 30 cases of acetabular defects were selected in our hospital,including 13 cases of acetabulum hypoplasia,acetabulum fracture malunion after trauma in 5 cases,6 patients with rheumatoid arthritis,ankylosing spondylitis hip lesions,6 cases were performed total hip replacement,take the acetabulum deepening,double cone spiral acetabulum,autologous bone graft and structural methods such as titanium mesh and bone graft line true acetabular reconstruction,all patients preoperative CT three-dimensional reconstruction,with Harris scoring criteria.Results Followed up for 6～36 months,has not occurred during the follow-up period of artificial hip prosthesis loosening and fracture around,etc.Harris scoring（36±6.5） preoperatively,postoperative（93±5.2）.Conclusion Deformity of total hip replacement for defects of acetabulum,through the acetabulum,Zweymulle double cone spiral acetabulum,grain pressure distribution,structural bone graft autologous bone graft and titanium mesh and bone graft and so on the many kinds of methods can be a very good reconstruction of acetabulum,restore good stability and the Harris score,can achieve very good effect.