微创短柄AccoladeⅡ在成人CroweⅠ型发育性髋关节发育不良髋关节置换中的应用

Accolade II short stem for Crowe type I developmental dysplasia of the hip in adults

背景:目前微创短柄的出现,相对全涂层锥形柄来说,有着更优异的股骨髓腔匹配度,极大的降低假体微动的风险。目的:进一步验证微创短柄AccoladeⅡ在CroweⅠ型发育性髋关节发育不良人工全髋关节置换中的应用效果。方法:统计分析应用AccoladeⅡ生物型股骨柄假体人工全髋关节置换治疗16例CroweⅠ型发育性髋关节发育不良患者的临床资料,比较患者关节置换前后的双下肢长度差异变化,同时观察置换前后12周患者疼痛、髋关节功能情况及术后一般状况。结果与结论:(1)关节置换前后双下肢长度差异变化有显著性意义(P<0.05),置换前双下肢等长10例(62%),置换后15例(94%);(2)关节置换后髋臼外展角41°-54°(平均46.9°);(3)目测类比评分及Harris评分显著优于关节置换前;(4)术中出血量平均147 m L,手术时间平均72 min,住院时间平均7.2 d,(5)关节置换后3个月所有患者恢复良好无并发症;(6)结果表明:应用AccoladeⅡ生物型股骨柄假体的人工全髋关节置换治疗CroweⅠ型发育性髋关节发育不良安全、可靠,置换后髋关节功能恢复良好。

BACKGROUND:Compared with the cone stem,short stem holds good matching with femoral canal,and remarkably reduces the risk of prosthesis loosening.OBJECTIVE:To further investigate the clinical efficacy of AccoladeⅡstem for Crowe type I developmental dysplasia of the hip.METHODS:Clinical data of 16 patients with Crowe type I developmental dysplasia of the hip undergoing total hip arthroplasty using Accolade II stem were collected,the length of both lower limbs before and after surgery was compared,and the Visual Analogue Scale,functional recovery of the hip and general conditions were observed at 12 weeks postoperatively.RESULTS AND CONCLUSION:(1)The change in length of both lower limbs before and after surgery had significant difference(P〈0.05),and 10 patients(62%)with the same length of both lower limbs before surgery,and 15 bases(94%)after surgery.(2)The postoperative acetablar abducent angle was 41°-54°(average 46.9°).(3)The Visual Analogue Scale and Harris hip scores after surgery were significantly improved compared with baseline(P〈0.05).(4)The intraoperative blood loss was 147 mL on average,the mean operation time was 72 minutes,and the hospitalization time was 7.2 days.(5)All patients recovered well and no complications occurred at 3 months postoperatively.(6)To conclude,AccoladeⅡstem is safe and reliable for Crowe type I developmental dysplasia of the hip,and exhibits good functional recovery of the hip.