先髋臼杯在成人髋关节发育不良全髋关节置换术中的疗效观察

Clinical observation of 15° face-changing acetabular cup in total hip replacement for the treatment of developmental dysplasia of hip

目的 ：探讨先髋臼杯在全髋关节置换术（THR）治疗CroweⅡ型成人髋关节发育不良（DDH）的早期疗效。方法：自2001年9月至2013年7月,采用先髋臼杯对18例（18髋）CroweⅡ型DDH患者行THR,其中男13例,女5例;年龄42~60岁,平均47.6岁;病程9~22年,平均13.5年。术前患者均有髋关节疼痛,肢体短缩,髋关节功能受限。术前1 d及术后12个月分别进行Harris髋关节评分;术后1周对髋臼假体覆盖率进行影像学评价。结果：术后18例（18髋）获得随访,时间12~24个月,平均17个月。手术切口均Ⅰ期愈合。术后无深静脉血栓、髋关节脱位、感染及假体松动等并发症发生,随访期内无需要手术翻修病例。术后1周X线片示髋臼假体覆盖率均大于80%。Harris评分由术前的42.67±5.06分提高到术后12个月的94.79±3.27（t=-45.269,P〈0.001）。结论：对CroweⅡ型DDH患者,采用先髋臼杯进行THR,可获得较高的髋臼假体覆盖率及满意的早期临床疗效。

Objective： To explore early clinical effect of acetabular cup in total hip replacement for the treatment of Crowe Ⅱ developmental dysplasia of hip. Methods：Eighteen patients （18 hips） with Crowe type Ⅱ developmental dysplasia of hip were treated with total hip replacement from September 2001 to July 2013. Among them,including 13 males and 5 females aged from 42 to 60 years old with an average of 47.6 years old ; the courses of diseases ranged from 9 to 22 years with an average of 13.5 years. All the patients had hip joint pain ,limb shortening and limited hip function before operation. Harris score of hip joint were used to evaluate recovery of function at 1 day and 12 months after operation. Prosthetic coverage of aeetabular cup at 1 week after operation was observed by using radiography. Results：Eighteen patients （18 hips） were followed up from 12 to 24 months with an average 17 months. All incisions were healed at stage Ⅰ . No deep vein thrombosis,hip dislocation, periprosthetie joint infection and prosthesis loosening were occurred. No revision surgery during follow-up period. Prosthetic coverage of aeetabular cup was more than 80% at 1 week after operation. Harris score were increased from 42.6±5.06 before operation to 94.79±3.27 at 12 months after operation（t=-45.269 ,P〈0.001 ）. Conclusion： For type Crowe Ⅱ developmental dysplasia of hip patients, 15° face-changing acetabular cups in THR could obtain higher actebular component coverage rate and satisfactory early clinical effects.