强直性脊柱炎患者髋关节置换术的时机及其对预后的影响

The influence of hip arthroplasty timing on prognosis of patients with ankylosing spondylitis

目的探讨强直性脊柱炎患者行髋关节置换术的时机及其对预后的影响。方法根据患者术前髋关节总被动活动度是否为0°,将患者分为强直组(17例)与非强直组(15例),对比两组术后12个月的Harris评分、WOMAC评分、髋关节被动屈曲度、Bath强直性脊柱炎功能指数(BASFI)的差异。结果患者均获得随访,时间12~64个月。术后12个月时,两组WOMAC评分比较差异无统计学意义(P>0.05),Harris评分、髋关节被动屈曲活动度和BASFI两组比较差异有统计学意义(P<0.05)。末次随访时,臼杯外展角和前倾角:强直组分别为42°(30°,52°)和18°(2°,29°),非强直组分别为44°(32°,55°)和20°(7°,29°),两组比较差异均无统计学意义(P>0.05)。结论强直性脊柱炎患者在符合手术指针时,相对早期行THA治疗可能会取得更好的预后。

Objective To investigate the influence of hip arthroplasty timing on prognosis of patients with ankylosing spondylitis.Methods Patients were divided into two groups:stiffness group(17 cases)and the non-stiffness group(15 cases)according to whether the general passive activity of patients was 0°before operation.The differences in Harris score,WOMAC scores,passive flexion activity degrees and the Bath ankylosing spondylitis functional index(BASFI)were compared between two groups at 12 months of postoperation.Results All patients were followed-up for 12~64 months,there was no statistical difference between the two groups in WOMAC scores(P>0.05),and there were statistical differences between the two groups in Harris score,hip passive flexion activity degree and BASFI at 12 months after operation(P<0.05).The angle of abduction and anteversion of the cup:stiffness group of 42°(30°,52°)and 18°(2°,29°),the non-stiffness group of 44°(32°,55°)and 20°(7°,29°),there were no statistical significance between the two groups at the last follow-up(P>0.05).Conclusions Ankylosing spondylitis patients can achieve better prognosis when taken hip arthroplasty relatively early,if surgical indications are indicated.