髋臼中心化的全髋关节置换术治疗髋关节发育不良型骨关节炎的疗效探讨

Study on the Effect of Acetabular Centralization of Total Hip Dysplasia Osteoarthritis for the Treatment of Osteoarthritis Caused by Developmental Dysplasia of the Hip

目的综合评价髋臼中心化的髋关节置换术(THA)治疗髋关节发育不良型骨关节炎的临床效果。方法将208例(245髋)接受THA手术的髋关节发育不良型骨关节炎患者按治疗时间进行分组,对照组103例(115髋)按Harris常规手术方法予以治疗,观察组105例(130髋)应用髋臼中心化手术技术进行处理。术前、术后随访时测量泪滴与髋旋转中心的水平距离,利用Harris髋关节评分评价关节功能,观察髋臼位置及发育情况,统计术中出血量、引流量及住院时间。结果两组术前下肢短缩、Harris评分结果比较无统计学意义(P>0.05);观察组术后下肢短缩和Harris评分、术中出血量和引流量均明显优于对照组(P<0.05);观察组术后X线片上髋臼旋转中心更接近于真实的髋臼旋转中心,与对照组比较有显著差异(P<0.05)。结论髋关节发育不良型骨关节炎应用髋臼中心化的THA术在纠正旋转中心位置、髋臼假体固定及改善髋关节功能方面发挥显著疗效。

Objective To explore the effect of acetabular centralization of total hip dysplasia osteoarthritis for the treatment of osteoarthritis caused by Developmental dysplasia of the hip （DDH）. Methods 208 patients （245 hips） who received THA surgery for hip dysplasia osteoarthritis were divided into two groups according to the treatment time, with 103 cases （I 15 hips） in the control group treated by conventional Harris surgery method, and 105 cases （130 hips） in the observation group treated with acetabular centralization of total hip dysplasia osteoarthritis. The distance between teardrops and rotating center of hips was measured by the preoperative and postoperative follow-up, and Harris hip score was used to evaluate the joint function, the acetabular position and its development were observed, and the bleeding amount, volume of drainage and hospital stay were recorded. Results There were no difference in leg length discrepancy and Harris scoring results between the two groups before the treatment （P 〉0.05）; yet after the treatment, leg length discrepancy and Harris scoring results, intraoperative blood loss and volume of drainage in observation group were significantly better than those in control group （P 〈0.05）. The postoperative distance between teardrops and rotating center of hips showed by the X-ray slice in the observation group was more closer to the actual position, and there was a significant difference between the two groups in this aspect （P〈0.05）. Conclusions The acetabular centralization of total hip dysplasia osteoarthritis in the treatment of osteoarthritis caused by DDH can correct the position of rotating center, fix the aeetabular prosthesis and improve the function of hip joint, which is of significant curative effect.