内侧突出技术在全髋关节置换术治疗成人DDH中的应用疗效评价

Evaluation of medial protrusio technique in total hip arthroplasty for adult with developmental dysplasia of the hip

目的评价全髋关节置换术(THA)中运用内侧突出技术治疗成人DDH患者的疗效。方法对2008年2月至2013年6月于本院因DDH继发骨性关节炎行THA治疗的30例(36髋)患者的临床资料进行回顾性分析。其中,男7例,女23例;年龄33~62岁,平均54岁。用Harris髋关节评分系统评价患者髋关节功能。根据骨盆平片及患髋正、侧位X线片观察臼杯覆盖、位置及假体是否松动。结果患者随访时间5.5~11年,平均6.8年。Harris评分术前平均(32.0±6.5)分,术后末次随访平均(86.0±11.0)分,术前与术后髋关节功能改善差异具有统计学意义(P<0.05),Trendelenburg征阴性,无跛行。髋臼覆盖率(87.0±11.0)%,外展角(46.7±3.5)°,髋臼旋转中心内移距离(11.2±7.3) mm,所有患者臼杯内缘达到或超过(<25%)Kohler线。截至末次随访无感染、假体松动、假体周围骨折等并发症发生。结论运用内侧突出技术治疗成人DDH,操作简单,可在真臼附近重建髋臼旋转中心,疗效满意。

Objective To evaluate the effect of medial protrusio technique in total hip arthroplasty for adult with developmental dysplasia of the hip. Methods The clinical data of 30 patients(36 hips) who had undergone total hip arthroplasty for DDH from February 2008 to June 2013 were analyzed. There were 7 males and 23 females, aged from 33 to 62 years old(averaging 54 years old). Harris hip score was used to assess the function of patients’ hip. According to the X-ray of the hip, we measured the coverage rate of the acetabulum and observed if prosthesis loosening happened. Results Thirty patients were followed up for 5.5 to 11 years(averaging 6.8 years). Harris hip score was(32.0±6.5) before the surgery and(86.0±11.0) at the last follow-up visit, and there were significant differences between them(P<0.05).Trendelenburg sign and cripple wasn’t found. The coverage rate of the acetabular was(87.0±11.0) %. The average inclination angle was(46.7±3.5) °. The distance of medial placement was(11.2±7.3) mm. The cup had reach or exceeded(<25%) the Kohler line. No hip infection, prosthesis loosening as well as periprosthetic fracture happened during our study. Conclusion The effect of THA with medial protrusio technique is satisfactory. It’s a simple way to reconstruct the cup in or around the real acetabulum.