快速破坏性髋关节病国内外研究进展

Research progress on rapidly destructive hip disease at home and abroad

快速破坏性髋关节病(RDHD)是一种以髋关节,尤其是股骨头、股骨颈骨质迅速破坏从而导致髋关节功能迅速下降并伴有髋关节剧烈疼痛的疾病,人群发病率很低,60岁以上老年女性发病率相对较高。回顾性分析国内外相关研究文献,RDHD的疾病名称、定义及发病机制等均存在明显争议,较为常用的疾病名称为快速破坏性髋关节病,影像学以中晚期股骨头、股骨颈明显骨质破坏缺损为特征性表现,结合患者疾病病程可明确诊断,但早期影像学无有诊断价值表现,患者症状体征也不具有特异性,故而早期诊断困难。目前的研究认为其发病与患者的骨质疏松状态、髋关节生物力学改变及细胞、细胞因子活化等多种因素相关,但具体的生理病理过程暂未明确。RDHD治疗早中期以对症及抗骨质疏松治疗为主,全髋关节置换术可用于晚期功能受限患者的手术治疗,但术后假体松动的发病率较高。

Rapidly destructive hip disease（ RDHD） is a disease characterized by rapid destructive of the bone of the hip,especially the femoral head and neck,which could causes a rapidly function decline and severe pain of the hip. The incidence rate of RDHD is very low,the rate of the women over 60 years is a little higher than others. A retrospective analysis of the relevant literature home and abroad find than the disease name,the definition and the pathogenesis of RDHD have obvious disputes. The commonly used disease name is rapidly destructive hip disease, which could be more exact. The imaging findings of RDHD are characterized by the obvious bone destruction and defect of the femoral head and neck in the middle and late stages,the diagnosis can be made with the disease course. However,early imaging doesn’t have diagnostic value,and the symptoms and signs aren’t specific,so the early diagnosis is much difficult. The present research suggests that the incidence of RDHD is related to variety factors such as osteoporosis,biomechanical changes of the hip and the activation of cell or cytokine,but the specific physiological and pathological process isn’t clear now. Early and mid-term treatments of RDHD are mainly the symptomatic treatment and the anti-osteoporosis treatment. Total hip arthroplasty can be used for surgical treatment of patients with advanced functional limitation,but the incidence rate of prosthesis loosening is higher.