| 全髋关节置换术治疗非功能位髋关节骨性强直12例17髋 |
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投稿时间：2010-09-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 闵重函 |
MIN Zhong-han |
浙江中医药大学附属嘉兴中医院骨科12病区，浙江 嘉兴 314001 |
The 12th District,Department of Orthopaedics,TCM Hospital of Jiaxing Affiliated to Zhejiang University of TCM,Jiaxing 314001,Zhejiang,China |
min.af.1@163.com |
| 周瑛 |
ZHOU Ying |
浙江中医药大学附属嘉兴中医院骨科12病区，浙江 嘉兴 314001 |
The 12th District,Department of Orthopaedics,TCM Hospital of Jiaxing Affiliated to Zhejiang University of TCM,Jiaxing 314001,Zhejiang,China |
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| 张洪美 |
ZHANG Hong-mei |
中国中医科学院望京医院骨关节一科 |
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| 期刊信息：《中国骨伤》2011年，第24卷，第3期，第231-235页 |
| DOI：10.3969/j.issn.1003-0034.2011.03.016 |
| 基金项目: |
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中文摘要:
目的：对病理性非功能位髋关节骨性强直患者行全髋关节置换术，根据3年随访结果探讨治疗中的细节和过程，为临床工作积累更多经验。
方法：自2001年5月至2005年5月由门诊收治病理性非功能位髋关节骨性强直患者12例17髋，予全髋关节置换术，其中男5例，年龄32～54岁，平均43.25岁；女7例，年龄29～64岁，平均48.80岁。所有患者中强直性脊柱炎5例，先天性髋关节发育障碍继发关节病变4例，晚期类风湿患者3例。入组患者病程5.25～20年。术前患者均有关节畸形强直，失去正常功能，伴有静息痛，影像学提示相应患髋关节间隙消失、骨硬化伴骨小梁通过原股骨头位置至相应髋臼。以Harris评分系统随访，分别对术前，术后6个月、1年及3年结果进行统计分析。
结果：根据Harris评价系统，术前疼痛平均(1.18±3.32)分，功能平均(0.01±0.01)分，活动度平均(0.01±0.01)分及关节畸形平均(0.01±0.01)分，对比术后疼痛(40.00±0.01)分，功能(31.53±5.36)分，活动度(1.94±0.05)分及关节畸形(4.00±0.01)分，差异均存在统计学意义(P<0.05).由于功能渐进性的改善，使总分在术后6个月、1年及3年差异均有统计学意义，平均分分别为(77.47±5.34)分、(80.95±4.01)分及(82.90±3.39)分。在关节功能上步态、支具使用、上下楼梯、穿脱鞋袜、坐车于术后6个月均较术前有显着改善，分别为(9.59±1.54)分、(8.88±2.69)分、(3.29±0.99)分、(3.75±0.66)分及(6.01±0.01)分；而前3项在术后1年较术后6个月差异仍有统计学意义，分别为(10.47±1.18)分、(10.06±1.75)分及(3.76±0.66)分。在关节活动度上各向活动角度均在术后实现一次性矫正并持久维持稳定。所有患者未发生神经损伤并发症，康复情况良好。
结论：经3年随访观察，全髋关节置换术治疗病理性非功能位髋关节骨性强直效果良好，可有效改善患者生活质量。 |
| 【关键词】髋关节 关节强直 关节成形术，置换，髋 随访研究 |
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| Total hip replacement for the treatment of hip bony fused in non-functional position(17 hips of 12 cases) |
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ABSTRACT
Objective: To explore the key points in the treatment of hip pathological bony fused in non-functional position with total hip replacement,especially to find out the main reasons for improving the joint function and the patients' life quality before and after the operation. And to accumulate more experience for further clinical treatment.
Methods: From May 2001 to May 2005,12 patients with hip bony fused in non-functional position were treated with total hip replacement. There were 5 males(ranging in age from 32 to 54 years,averaged 43.25 years) and 7 females( ranging in age from 29 to 64 years,averaged 48.80 years). The patients suffered from ankylosing spondylitis(AS,5 patients),developmental dysplasia of the hip( DDH,4 patients),and rheumatoid arthritis(RA,3 patients). The course of the disease ranged from 5.25 to 20 years. All affected hips were bony fused,lost normal function and had rest pain. The X-ray showed there were no joint space left in the affected hips and trabecular bone crossed the femoral head to the acetabulum. The Harris evaluation system was performed before surgery,at 6,12 and the 36 months after surgery.
Results: The Harris evaluation system showed the joint replacement surgery can significantly improve the patients' life quality. The postoperative scores of pain was (40.00±0.01),joint function was (31.53±5.36),range of motion was(1.94±0.05)and the deformity was(4.00±0.01),which had significantly difference(P<0.05) from the scores of preoperative ones as the pain(1.18±3.32),joint function(0.01±0.01),range of motion(0.01±0.01)and the deformity(0.01±0.01). In the three year follow-up study,total scores had gradual improvement(P<0.05)in the 6,12 and the 36 months after the operation,which were(77.47±5.34),(80.95±4.01) and(82.90±3.39) respectively. The scores for limp,support,stairs,activities as wearing shoes or socks,and public transportation were(9.59±1.54),(8.88±2.69),(3.29±0.99),(3.75±0.66) and(6.01±0.01) respectively,and the former three,which were(10.47±1.18),(10.06±1.75) and (3.76±0.66),had continually improved in 12 months after the operation(P<0.05). Operation also solved the motion problem and made the joint remain stable. All the patients were recovered without complications of nerve injuries.
Conclusion: By the three year follow-up study,total hip replacement can significantly improve life quality of patients with hip pathological bony fused in non-functional position. |
| KEY WORDS Hip joint Ankylosis Arthroplasty,replacement,hip Follow-up studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闵重函,周瑛,张洪美.全髋关节置换术治疗非功能位髋关节骨性强直12例17髋[J].中国骨伤,2011,24(3):231~235 |
| 英文格式: | MIN Zhong-han,ZHOU Ying,ZHANG Hong-mei.Total hip replacement for the treatment of hip bony fused in non-functional position(17 hips of 12 cases)[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(3):231~235 |
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