目的:探究关节囊切开与髋关节镜分别结合髋臼周围截骨术治疗成人发育性髋关节发育不良的疗效。方法:回顾分析72例2021年5月至2022年6月入住我院的成人发育性髋关节发育不良患者的临床资料,分为关节囊切开组(n=35)和髋关节镜组(n=37)。...目的:探究关节囊切开与髋关节镜分别结合髋臼周围截骨术治疗成人发育性髋关节发育不良的疗效。方法:回顾分析72例2021年5月至2022年6月入住我院的成人发育性髋关节发育不良患者的临床资料,分为关节囊切开组(n=35)和髋关节镜组(n=37)。对比两组患者的手术情况,术前及术后采用髋骨X线检查测定髋关节情况,采用非骨关节炎髋关节评分(Non-Arthritis Hip Score,NAHS)测定患者关节功能,采用日常生活能力量表(Hip Outcome Score Activity of Daily Living Scale,HOS-ADL)测定患者活动能力,记录患者术后并发症发生情况。结果:两组患者手术情况,术后3 m术后髋关节情况对比均无明显差异(P>0.05),髋关节镜组相较于关节囊切开组术后3 m NAHS、HOS-ADL得分更高,坐骨神经损伤表现发生率明显更低(P<0.05)。结论:髋关节镜截骨术在短期改善成人发育性髋关节不良患者关节功能方面优势明显,可防止坐骨神经损伤。展开更多
背景 髋关节镜手术治疗临界型髋关节发育不良(borderline developmental dysplasia of the hip,BDDH)一直存在争议。目的 观察髋关节镜手术治疗BDDH术后2年以上疗效,探讨关节镜手术治疗BDDH的效果。方法 回顾性分析解放军总医院第一医...背景 髋关节镜手术治疗临界型髋关节发育不良(borderline developmental dysplasia of the hip,BDDH)一直存在争议。目的 观察髋关节镜手术治疗BDDH术后2年以上疗效,探讨关节镜手术治疗BDDH的效果。方法 回顾性分析解放军总医院第一医学中心运动医学科2016年9月-2020年6月收治的BDDH患者。依据术前影像学资料和术中镜下病理,给予相应手术处理。截至2023年4月,借助问卷星电话通话调查患者术前和术后2年关节功能评价改良Harris髋关节评分(modified Harris hip score,mHHS)、国际髋关节结果评分(international hip outcome tool,IHOT-12)、疼痛视觉模拟评分(visual analog scale,VAS)和术后患者满意度评分。结果 52例患者纳入研究,男15例,女37例,平均年龄(30.75±8.39)岁,平均髋臼外侧中心边缘角(lateral center-edge angle,LCEA)为21.97°±2.14°。术中镜下盂唇撕裂、髋臼和股骨头软骨损伤发生率分别为100%、44.23%和32.69%。所有患者在髋臼边缘骨质最小磨除基础上行损伤盂唇的修整固定和关节囊切开后的缝合术,Cam畸形磨除和异常髂前下棘(anterior inferior iliac spine,AIIS)减压成形术分别占88.46%和57.69%。术后平均随访(44.35±10.96)个月,术后mHHS评分(82.88±9.15 vs 44.38±15.05)、i HOT-12评分(83.62±9.59 vs 41.18±13.20)、VAS评分(1.83±1.02 vs 6.42±1.29)较术前均有显著改善(P均<0.01),差异有统计学意义。结论 BDDH多由机械性因素导致盂唇和软骨损伤,髋臼边缘最小磨除基础上的盂唇修整固定、Cam畸形和2~3型AIIS的充分磨除减压以及关节囊的缝合,可获得满意的临床疗效。展开更多
Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ＇high-riding＇ hip. It is a common cause of secondary osteoarthritis in you...Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ＇high-riding＇ hip. It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty （THA） for coxarthrosis. The aim of this study was to evaluate efficiency and safety of THA using Zweym（311er hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip （DDH） in adults. Methods From January 2000 to February 2008, 35 patients （40 hips） with developmental dysplasia of the hip were included. Five were male and 30 were female, with ages ranging from 26 to 65 years and an average age of 45 years. According to Hartofilakidis classification, there were type I in 5 hips, type II in 20 hips, type III in 15 hips. All the patients were performed the THA using the Zweym011er hip implant. The preoperative average Harris score was 44. The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients. The patients mainly suffered from pain and claudication. Clinical and radiological results were analyzed. The Harris score was used for outcome measurement. Results Thirty five patients （40 hips） were followed and the mean follow-up period was 46 months （ranged from 24 months to 96 months）. The latest follow-up average Harris score was 88.9 （97.1% of good rate）. All the patients were pain-free and there was no sign of infection, aseptic loosening and subsidence. Conclusions In summary, THA using Zweym011er hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults. The key techniques for the total hip replacement are as follows： good preoperative plan, firmly placing the acetabular component in the true acetabulum, proper preparation of proximal femur, suitable femoral component choosing and improving the techniques of the bone graft.展开更多
Background： The prevalence of developmental dysplasia of the hip （DDH） is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults. Methods： In this study, we performed a cross-sectional sur...Background： The prevalence of developmental dysplasia of the hip （DDH） is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults. Methods： In this study, we performed a cross-sectional survey of a nationally representative sample of Chinese adults. All participants underwent questionnaire investigation, physical examination, and X-ray examination. Factors associated with DDH were analyzed with logistic regression. Results： We invited 29,180 individuals aged 18 years and over to participate, randomly selected from 18 primary sampling units （street districts in urban areas and townships in rural areas）. The survey and examination were completed in 25,767 people （I 0,296 men and 15,471 women）. DDH was diagnosed in 391 people, yielding an overall DDH prevalence of 1.52%. Based on this information, we estimate the number of individuals with DDH in China to be approximately 16.05 million. DDH prevalence increased with age （odds ratio = 1.53 [1 .03-2.27], P = 0.036）, was significantly higher among women than men （2.07% vs. 0.75%, P 〈 0.001）, and was higher among rural residents than urban residents （1.75% vs. 1.29%, P 〈 0.001）. Economic development was independently associated with the presence of DDH. There was no evidence of an association between body mass index alone, education~ or current smoking or drinking and risk of DDH （P 〉 0.05）. Conclusions： DDH has become an important public health problem. Special attention should be paid to residents with DDH. Screening for DDH should be performed in China.展开更多
目的:研究成人先天性髋关节发育不良(development dislocation of the hip,DDH)全髋关节置换术中采用骨牵引对坐骨神经麻痹的预防作用。方法:选取笔者所在医院2011年10月~2015年10月收治的28例成人DDH患者(共37髋),所有病例均接受全髋...目的:研究成人先天性髋关节发育不良(development dislocation of the hip,DDH)全髋关节置换术中采用骨牵引对坐骨神经麻痹的预防作用。方法:选取笔者所在医院2011年10月~2015年10月收治的28例成人DDH患者(共37髋),所有病例均接受全髋关节置换术,手术前给予骨牵引,评估手术后髋关节功能及坐骨神经损伤情况。结果:28例患者的平均随访时间为(1 8.6±5.4)个月,术后平均Harris评分为(82.6±6.3)分,37髋髋关节功能优良率为72.9%,与术前髋关节功能比较差异具有统计学意义(P<0.05)。结论:成人DDH行全髋关节置换术术前给予骨牵引对改善髋关节功能具有良好作用,并且能够有效抑制术后坐骨神经损伤的发生,具有确切临床应用价值。展开更多
目的本研究拟探究3D打印技术用于人工全髋关节置换术治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)的临床应用效果。方法纳入2013年1月至2016年6月昆明医科大学第一附属医院骨科Crowe各型成人DDH患者共20例,CroweⅠ...目的本研究拟探究3D打印技术用于人工全髋关节置换术治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)的临床应用效果。方法纳入2013年1月至2016年6月昆明医科大学第一附属医院骨科Crowe各型成人DDH患者共20例,CroweⅠ型2例,CroweⅡ型2例,CroweⅢ型8例,CroweⅣ型8例。所有患者制造出与实体1∶1的髋关节模型,并制定出合适的手术方案并按方案实施手术。记录患者的一般情况、并发症和患者患髋的功能指标(活动度、疼痛视觉模拟评分、髋关节功能评分)。结果患者平均手术时间为(75.25±20.42)min,下床时间为术后(2.90±0.72)d,平均住院时间为(15.35±5.95)d。患者的髋关节功能评分(harris hip score,HHS)术前平均(51.30±8.02)分,末次随访(86.50±5.85)分,差异有统计学意义(P<0.001);视觉模拟评分(visual analogue scale,VAS)术前为(5.51±1.19)分,末次随访为(1.05±0.88)分,差异有统计学意义(P<0.001)。所有患者均获随访,随访期间未出现关节感染、假体松动、假体脱位、坐骨神经损伤等并发症。结论 3D打印技术治疗髋关节发育不良的患者,特别是CroweⅢ/Ⅳ型患者效果显著。展开更多
目的探讨3D打印技术制造骨盆模型对DDH患者进行人工髋关节置换术的临床效果。方法选择2016-06~2017-01来我院接受人工髋关节置换治疗的成人髋关节发育不良(developmental dysplasia of the hip in adults,DDH)84例患者作为研究对象,按...目的探讨3D打印技术制造骨盆模型对DDH患者进行人工髋关节置换术的临床效果。方法选择2016-06~2017-01来我院接受人工髋关节置换治疗的成人髋关节发育不良(developmental dysplasia of the hip in adults,DDH)84例患者作为研究对象,按照随机编号方法平均分为两组,分别为3D打印组和对照组。3D打印组DDH患者采用3D打印技术制造骨盆模型的方法进行治疗,对照组采用常规技术实施治疗。对比两组患者人工髋关节置换术结果情况,记录手术治疗时间、术中出血量、术后引流量指标数据,同时对患者治疗后效果进行统计分析,此外对术后并发症发生情况进行观察和统计。结果3D打印组患者手术操作时间、出血量、术后引流量均显著低于对照组(P<0.05),治疗后两组患者Harris评分相比之前均有所好转,治疗后3D打印组患者Harris评分结果明显优于对照组(P<0.05),此外3D打印组患者治疗后并发症发生率明显低于对照组(P<0.05)。结论 3D打印技术相比其他方法制造骨盆模型可以有效地提升DDH患者人工髋关节置换术的治疗效果,具有显著的并发症少、手术操作安全、可靠等优势,在临床治疗中具有理想的使用价值。展开更多
文摘目的:探究关节囊切开与髋关节镜分别结合髋臼周围截骨术治疗成人发育性髋关节发育不良的疗效。方法:回顾分析72例2021年5月至2022年6月入住我院的成人发育性髋关节发育不良患者的临床资料,分为关节囊切开组(n=35)和髋关节镜组(n=37)。对比两组患者的手术情况,术前及术后采用髋骨X线检查测定髋关节情况,采用非骨关节炎髋关节评分(Non-Arthritis Hip Score,NAHS)测定患者关节功能,采用日常生活能力量表(Hip Outcome Score Activity of Daily Living Scale,HOS-ADL)测定患者活动能力,记录患者术后并发症发生情况。结果:两组患者手术情况,术后3 m术后髋关节情况对比均无明显差异(P>0.05),髋关节镜组相较于关节囊切开组术后3 m NAHS、HOS-ADL得分更高,坐骨神经损伤表现发生率明显更低(P<0.05)。结论:髋关节镜截骨术在短期改善成人发育性髋关节不良患者关节功能方面优势明显,可防止坐骨神经损伤。
文摘背景 髋关节镜手术治疗临界型髋关节发育不良(borderline developmental dysplasia of the hip,BDDH)一直存在争议。目的 观察髋关节镜手术治疗BDDH术后2年以上疗效,探讨关节镜手术治疗BDDH的效果。方法 回顾性分析解放军总医院第一医学中心运动医学科2016年9月-2020年6月收治的BDDH患者。依据术前影像学资料和术中镜下病理,给予相应手术处理。截至2023年4月,借助问卷星电话通话调查患者术前和术后2年关节功能评价改良Harris髋关节评分(modified Harris hip score,mHHS)、国际髋关节结果评分(international hip outcome tool,IHOT-12)、疼痛视觉模拟评分(visual analog scale,VAS)和术后患者满意度评分。结果 52例患者纳入研究,男15例,女37例,平均年龄(30.75±8.39)岁,平均髋臼外侧中心边缘角(lateral center-edge angle,LCEA)为21.97°±2.14°。术中镜下盂唇撕裂、髋臼和股骨头软骨损伤发生率分别为100%、44.23%和32.69%。所有患者在髋臼边缘骨质最小磨除基础上行损伤盂唇的修整固定和关节囊切开后的缝合术,Cam畸形磨除和异常髂前下棘(anterior inferior iliac spine,AIIS)减压成形术分别占88.46%和57.69%。术后平均随访(44.35±10.96)个月,术后mHHS评分(82.88±9.15 vs 44.38±15.05)、i HOT-12评分(83.62±9.59 vs 41.18±13.20)、VAS评分(1.83±1.02 vs 6.42±1.29)较术前均有显著改善(P均<0.01),差异有统计学意义。结论 BDDH多由机械性因素导致盂唇和软骨损伤,髋臼边缘最小磨除基础上的盂唇修整固定、Cam畸形和2~3型AIIS的充分磨除减压以及关节囊的缝合,可获得满意的临床疗效。
文摘Background Developmental dysplasia encompasses a wide spectrum of hip pathology ranging from a shallow acetabulum to a completely dislocated ＇high-riding＇ hip. It is a common cause of secondary osteoarthritis in young adults and is the underlying diagnosis in up to 48% of patients requiring total hip arthroplasty （THA） for coxarthrosis. The aim of this study was to evaluate efficiency and safety of THA using Zweym（311er hip implant in the treatment of severe osteoarthritis secondary to developmental dysplasia of the hip （DDH） in adults. Methods From January 2000 to February 2008, 35 patients （40 hips） with developmental dysplasia of the hip were included. Five were male and 30 were female, with ages ranging from 26 to 65 years and an average age of 45 years. According to Hartofilakidis classification, there were type I in 5 hips, type II in 20 hips, type III in 15 hips. All the patients were performed the THA using the Zweym011er hip implant. The preoperative average Harris score was 44. The bilateral arthroplasty was performed in 5 patients and the unilateral arthroplasty in 30 patients. The patients mainly suffered from pain and claudication. Clinical and radiological results were analyzed. The Harris score was used for outcome measurement. Results Thirty five patients （40 hips） were followed and the mean follow-up period was 46 months （ranged from 24 months to 96 months）. The latest follow-up average Harris score was 88.9 （97.1% of good rate）. All the patients were pain-free and there was no sign of infection, aseptic loosening and subsidence. Conclusions In summary, THA using Zweym011er hip implant is a good treatment method for severe osteoarthritis secondary to DDH in adults. The key techniques for the total hip replacement are as follows： good preoperative plan, firmly placing the acetabular component in the true acetabulum, proper preparation of proximal femur, suitable femoral component choosing and improving the techniques of the bone graft.
文摘Background： The prevalence of developmental dysplasia of the hip （DDH） is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults. Methods： In this study, we performed a cross-sectional survey of a nationally representative sample of Chinese adults. All participants underwent questionnaire investigation, physical examination, and X-ray examination. Factors associated with DDH were analyzed with logistic regression. Results： We invited 29,180 individuals aged 18 years and over to participate, randomly selected from 18 primary sampling units （street districts in urban areas and townships in rural areas）. The survey and examination were completed in 25,767 people （I 0,296 men and 15,471 women）. DDH was diagnosed in 391 people, yielding an overall DDH prevalence of 1.52%. Based on this information, we estimate the number of individuals with DDH in China to be approximately 16.05 million. DDH prevalence increased with age （odds ratio = 1.53 [1 .03-2.27], P = 0.036）, was significantly higher among women than men （2.07% vs. 0.75%, P 〈 0.001）, and was higher among rural residents than urban residents （1.75% vs. 1.29%, P 〈 0.001）. Economic development was independently associated with the presence of DDH. There was no evidence of an association between body mass index alone, education~ or current smoking or drinking and risk of DDH （P 〉 0.05）. Conclusions： DDH has become an important public health problem. Special attention should be paid to residents with DDH. Screening for DDH should be performed in China.
文摘目的:研究成人先天性髋关节发育不良(development dislocation of the hip,DDH)全髋关节置换术中采用骨牵引对坐骨神经麻痹的预防作用。方法:选取笔者所在医院2011年10月~2015年10月收治的28例成人DDH患者(共37髋),所有病例均接受全髋关节置换术,手术前给予骨牵引,评估手术后髋关节功能及坐骨神经损伤情况。结果:28例患者的平均随访时间为(1 8.6±5.4)个月,术后平均Harris评分为(82.6±6.3)分,37髋髋关节功能优良率为72.9%,与术前髋关节功能比较差异具有统计学意义(P<0.05)。结论:成人DDH行全髋关节置换术术前给予骨牵引对改善髋关节功能具有良好作用,并且能够有效抑制术后坐骨神经损伤的发生,具有确切临床应用价值。
文摘目的本研究拟探究3D打印技术用于人工全髋关节置换术治疗成人髋关节发育不良(developmental dysplasia of the hip,DDH)的临床应用效果。方法纳入2013年1月至2016年6月昆明医科大学第一附属医院骨科Crowe各型成人DDH患者共20例,CroweⅠ型2例,CroweⅡ型2例,CroweⅢ型8例,CroweⅣ型8例。所有患者制造出与实体1∶1的髋关节模型,并制定出合适的手术方案并按方案实施手术。记录患者的一般情况、并发症和患者患髋的功能指标(活动度、疼痛视觉模拟评分、髋关节功能评分)。结果患者平均手术时间为(75.25±20.42)min,下床时间为术后(2.90±0.72)d,平均住院时间为(15.35±5.95)d。患者的髋关节功能评分(harris hip score,HHS)术前平均(51.30±8.02)分,末次随访(86.50±5.85)分,差异有统计学意义(P<0.001);视觉模拟评分(visual analogue scale,VAS)术前为(5.51±1.19)分,末次随访为(1.05±0.88)分,差异有统计学意义(P<0.001)。所有患者均获随访,随访期间未出现关节感染、假体松动、假体脱位、坐骨神经损伤等并发症。结论 3D打印技术治疗髋关节发育不良的患者,特别是CroweⅢ/Ⅳ型患者效果显著。
文摘目的探讨3D打印技术制造骨盆模型对DDH患者进行人工髋关节置换术的临床效果。方法选择2016-06~2017-01来我院接受人工髋关节置换治疗的成人髋关节发育不良(developmental dysplasia of the hip in adults,DDH)84例患者作为研究对象,按照随机编号方法平均分为两组,分别为3D打印组和对照组。3D打印组DDH患者采用3D打印技术制造骨盆模型的方法进行治疗,对照组采用常规技术实施治疗。对比两组患者人工髋关节置换术结果情况,记录手术治疗时间、术中出血量、术后引流量指标数据,同时对患者治疗后效果进行统计分析,此外对术后并发症发生情况进行观察和统计。结果3D打印组患者手术操作时间、出血量、术后引流量均显著低于对照组(P<0.05),治疗后两组患者Harris评分相比之前均有所好转,治疗后3D打印组患者Harris评分结果明显优于对照组(P<0.05),此外3D打印组患者治疗后并发症发生率明显低于对照组(P<0.05)。结论 3D打印技术相比其他方法制造骨盆模型可以有效地提升DDH患者人工髋关节置换术的治疗效果,具有显著的并发症少、手术操作安全、可靠等优势,在临床治疗中具有理想的使用价值。
