生物型全髋关节置换术结合打压植骨处理晚期类风湿性髋关节炎髋臼内陷的疗效

Clinical Efficacy of Total Hip Arthroplasty Combined with Compressive Bone Graft in Treatment of Acetabular Collapse in Advanced Rheumatoid Arthritis

目的探讨生物型全髋关节置换术结合自体打压植骨处理晚期类风湿性髋关节炎髋臼内陷的疗效.方法回顾性分析2014年1月至2016年12月昆明医科大学第一附属医院骨科收治的42例(51髋)类风湿性髋关节炎伴髋臼内陷的患者,采用生物型全髋关节置换术结合自体打压植骨重建髋臼.术前、术后分别对患者髋关节进行Harris评分和患侧髋关节的外展角度测量.结果 42例(51髋)均获随访.患者髋关节Harris评分由术前(40.49±1.58)分,至术后1 a末次随访(91.8±2.23)分,P<0.05;患侧髋关节的屈曲由术前(44.47±2.38)°,至术后1 a末次随访(95.61±2.04)°,P<0.05.结论生物型全髋关节置换术结合打压植骨治疗晚期类风湿性髋关节炎导致的髋臼内陷,可以取得较好的早期疗效.

Objective To evaluate the efficacy of total hip arthroplasty with autogenous compression bonegraft in the treatment of acetabular collapse in advanced rheumatoid arthritis （RA ） . Methods We madearetrospective analysis of 42 cases of -2016 in January 2014 in the First Affiliated Hospital of Kunming MedicalUniversity in December admitted to the Department of orthopedics （51 hips ） of rheumatoid arthritis of the hip withacetabular protrusion in patients with cementless total hip replacement combined with autologous bone graft impactionof acetabular reconstruction. The Harris score and abduction angle of the hip joint were measured before and after theoperation. Results 42 cases （ 51 hips ） were followed up. The hip Harris score ranged from 40.49 to 1.580, 91.8to 2.233 at the last follow-up, and the difference was statistically significant （ =-125.344, = 0.000） . Theflexion of the affected side hip increased from the preoperative （44.47 ＋ 2.386） DEG C to the last follow-up（ 95.61 ＋ 2.040） degree,and the difference was statistically significant （ T=-123.949,P = 0.000） . ConclusionBiological total hip arthroplasty combined with compressive bone graft for acetabular depression caused by advancedrheumatoid arthritis can achieve good early results.