Watson-Jone入路全髋关节置换术治疗晚期大骨节病致髋关节骨关节炎的临床疗效

Clinical effect of total hip arthroplasty via Watson-Jone approach in treatment of hip osteoarthritis caused by advanced Kashin-Beck disease

目的观察Watson-Jone入路全髋关节置换术治疗晚期大骨节病致髋关节骨关节炎的临床疗效。方法选择2018年1月至2019年6月入住五四一总医院骨科接受全髋关节置换术治疗的晚期大骨节病致髋关节骨关节炎患者46例作为观察对象,其中23例接受常规后外侧入路的患者作为对照组,另外23例接受Watson-Jone入路的患者作为研究组。比较分析两组患者在术前与术后不同时间段(3、6、12、24个月)的髋关节Harris评分、疼痛程度评定(视觉模拟评分法)以及术后随访并发症发生率。结果研究组与对照组术前髋关节Harris评分分别为(36.28±6.57)、(37.51±6.29)分,差异无统计学意义(t=0.65,P=0.520);术后3、6、12、24个月时分别为(86.65±5.26)、(80.91±5.39),(88.59±5.08)、(83.33±5.26),(90.37±4.55)、(85.05±4.61),(92.06±4.37)、(88.72±4.56)分,差异均有统计学意义(P均<0.05)。研究组与对照组术前髋关节疼痛程度评分分别为(8.08±0.45)、(7.96±0.49)分,差异无统计学意义(t=0.87,P=0.392);术后3、6、12、24个月时分别为(2.08±0.51)、(2.55±0.55),(1.68±0.46)、(2.07±0.41),(1.32±0.38)、(1.71±0.41),(1.01±0.22)、(1.18±0.28)分,差异均有统计学意义(P均<0.05)。研究组术后并发症总发生率为0(0/23),显著低于对照组(17.39%,4/23,χ^(2)=4.38,P=0.036)。结论在晚期大骨节病致髋关节骨关节炎患者的全髋关节置换术中,采取Watson-Jone入路较后外侧入路能显著减轻患者髋关节疼痛、提升髋关节功能,且术后并发症较少,有利于术后康复。

Objective To observe the clinical effect of total hip arthroplasty via Watson-Jone approach in treatment of hip osteoarthritis caused by advanced Kashin-Beck disease.Methods Forty six patients with hip osteoarthritis caused by advanced Kashin-Beck disease who were admitted to Department of Orthopedics of 541 General Hospital from January 2018 to June 2019 were selected as observation subjects,of which 23 patients received the conventional posterolateral approach as the control group,and the other 23 patients received the Watson-Jone approach as the study group.The Harris scores of the hip joints,the degree of pain(visual analogue scale),and complication rate of postoperative follow-up were compared between the patients of two groups before and after operation at different time periods(3,6,12,24 months).Results The preoperative Harris scores of the study group and the control group were(36.28±6.57)and(37.51±6.29)points,respectively,and the difference was not statistically significant(t=0.65,P=0.520);at 3,6,12 and 24 months after operation,the scores were(86.65±5.26),(80.91±5.39),(88.59±5.08),(83.33±5.26),(90.37±4.55),(85.05±4.61),(92.06±4.37),and(88.72±4.56)points,the differences were statistically significant(P<0.05).The preoperative hip pain scores of the study group and the control group were(8.08±0.45)and(7.96±0.49)points,respectively,and the difference was not statistically significant(t=0.87,P=0.392);at 3,6,12 and 24 months after operation,the scores were(2.08±0.51),(2.55±0.55),(1.68±0.46),(2.07±0.41),(1.32±0.38),(1.71±0.41),(1.01±0.22),and(1.18±0.28)points,the differences were statistically significant(P<0.05).The complication rate of postoperative in the study group was 0(0/23),which was significantly lower than that[17.39%(4/23)]of the control group(χ^(2)=4.38,P=0.036).Conclusion Watson-Jone approach is adopted in total hip arthroplasty for patients with hip osteoarthritis caused by advanced Kashin-Beck disease,which can significantly reduce the pain of the hip joint and improve the function of the hip joint,with fewer postoperative complications,and is conducive to postoperative rehabilitation.