全髋关节置换术治疗强直性脊柱炎髋关节强直84例的长期效果观察

Long-term effect of total hip arthroplasty on ankylosing spondylitis complicated with ankylosing hip

目的：探讨全髋关节置换术治疗强直性脊柱炎髋关节强直的长期效果。方法1992年6月至2006年6月采用全髋关节置换术治疗强直性脊柱炎髋关节强直84例（146髋），术后对患者进行随访，观察手术前后髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度的改善情况及术后并发症，评估疗效。结果术后平均随访12.5年（9～20年），至末次随访：患者髋关节疼痛指数、髋关节 Harris 评分、髋关节活动度均得到明显改善，术前与末次随访之间比较差异有统计学意义（P〈0.05）；术后并发症发生率为6.2%，其中股骨柄无菌性松动下沉者6髋（4.1%），髋臼松动移位2髋（1.4%），异位骨化1例（0.7%），未发现神经血管损伤、假体脱位、感染等并发症。结论全髋关节置换术是治疗强直性脊柱炎髋关节强直的一种有效方法，长期疗效满意。

Objective To investigate the long-term effect of total hip arthroplasty on ankylosing spondylitis compli-cated with ankylosing hip. Methods From June 1992 to June 2006,84 cases（146 hips）of ankylosing spondylitis com-plicated with ankylosing hip were treated by total hip arthroplasty. Preoperative and postoperative outcomes with hip pain in-dex（0 - 10）,Harris score,the improvement of hip joint activity and complications were observed to evaluate the curative effect. Results The mean follow-up was 12. 5 years（9 - 20 years）. To the final follow-up,hip pain index,Harris score and hip joint activity were obviously improved,there were significant differences（P〈 0. 05）between preoperative and final follow-up;the incidence of postoperative complications was 6. 2% ,among which 6 hips（4. 1% ）with aseptic loosening and sinking,2 hips（1. 4% ）with acetabulum loosening and shift,and heterotopic ossification in 1 case（0. 7% ）,no nerve and vascular injury,prosthesis dislocation,or infection. Conclusions Total hip arthroplasty is an effective method for the treatment of ankylosing spondylitis complicated with ankylosing hip,with satisfying long-term effect.