全髋关节置换术治疗先天性髋关节脱位

Treatment of congenital dislocated hip by total hip replacement

目的 :探讨全髋关节置换术治疗成人先天性髋关节脱位伴骨性关节炎的经验。方法 :从 1996年 9月～2 0 0 3年 2月 ,对 14例 (2 0髋 )成人先天性髋关节脱位伴骨性关节炎患者 ,进行了全髋关节置换。其中双侧 10例 ,单侧 4例。病人全是女性 ,平均年龄 45岁 (3 5～ 67岁 )。双侧全髋置换 6例 ,单侧 8例。结果 :术后伤口均一期愈合 ,随访 6个月～ 6年 ,平均 4年 8个月 ;平均Harris评分由术前的 3 2 43分恢复到术后 1年的 90 15分。截止目前无 1例翻修。术后 6个月 ,患者均能下地行走 ,生活自理且恢复日常工作。结论 :全髋关节置换术是治疗成人先天性髋关节脱位伴骨性关节炎的有效方法 ,但手术难度较大。对于此类病人 ,充分理解全髋置换的复杂性和细致周密的治疗方案是成功的关键。

Objective:To explore the experiences of total hip replacement in treating osteoarthritis secondary to congenital dislocation of the hip.Method:From Sep. 1996 to Feb. 2003,twenty hips in fourteen adult patients with osteoarthritis secondary to congenital dislocation of the hip undergone total hip replacement were included in this study.There were 10 patients in bilateral hip and 4 patients in unilateral hip.They were all females,the age of the patients at surgery ranged from 35～67 years (mean 45 years).Six patients had a bilateral total hip replacement and 8 did unilateral one.Result:The incision healed well.The duration of follow-up ranged from 6 months to 6 years (mean 56 months).All the patients could walk independently,take care of themselves and return to previous job in 6 months postoperatively.The average Harris score was increased from preoperative 32.43 to 90.15 points in one year after operation.So far,there has been no revision.Conclusion:Total hip replacement is an effective method in treating osteoarthritis secondary to congenital dislocation of the hip and is a challenging work to the orthopaedic surgeon.It is critical to understand the complexities of total hip replacement and to plan operative interventions meticulously.