强直性脊柱炎髋关节非功能位骨性强直的人工全髋关节置换

Total hip arthroplasty for ankylosing spondylitis patients with non-functional position hip ankyloses

[目的]探讨强直性脊柱炎髋关节非功能位骨性强直的患者行人工全髋关节置换效果的因素,包括手术时机、手术方式、假体选择等。[方法]2011年1月~2014年1月对14例强直性脊柱炎导致髋关节非功能位骨性强直的患者行人工全髋关节置换术,其中男12例23髋,女2例3髋;年龄18~45岁,术前Harris评分平均28分。[结果]14例患者均获得随访,平均随访时间24个月。假体位置良好,无脱位等情况,活动度良好。[结论]对于强直性脊柱炎髋关节非功能位骨性强直的患者应尽早进行手术,应用生物型假体及精确的手术技术,可以获得良好的效果。

[Objective] To investigate the operative time,surgical procedure and prosthesis choice of total hip replacement for ankylosing spondylitis and hip bony ankyloses at non-functional positions. [Methods] Forteen patients with ankylosing spondylitis and hip ankyloses received total hip arthroplasties since 2011,including 12 males（ 23 hips） and 2 females（ 3hips）. The age at the time of the surgery ranged from 18 to 45 years old. The average Harris grade was 28 points. [Results]All forteen patients were followed up for an average time of 24 months. The positions of the prosthesis and ranges of motion of the hips were favorable. No dislocations of the prosthesis were found in the patients. The Harris scores were evidently improved after surgery（ mean 71; range,68-72 points）. [Conclusion] For patients with ankylosing spondylitis and hip ankyloses at non-functional positions,total hip replacement should be taken as early as possible. With proper prosthesis and precise operative technique,better results can be acquired.