| CroweⅢ型发育性髋关节发育不良全髋关节置换术中臼杯高位和解剖位安放的临床疗效对比分析 |
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投稿时间：2018-07-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 王振江 |
WANG Zhen-jiang |
濮阳市油田总医院, 河南 濮阳 457001 |
Puyang Oil Field General Hospital, Puyang 457001, Henan, China |
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| 强晓军 |
QIANG Xiao-jun |
濮阳市油田总医院, 河南 濮阳 457001 |
Puyang Oil Field General Hospital, Puyang 457001, Henan, China |
Qiangxiaojun@aliyun.com |
| 刘涛 |
LIU Tao |
濮阳市油田总医院, 河南 濮阳 457001 |
Puyang Oil Field General Hospital, Puyang 457001, Henan, China |
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| 期刊信息：《中国骨伤》2018年，第31卷，第10期，第922-926页 |
| DOI：10.3969/j.issn.1003-0034.2018.10.009 |
| 基金项目: |
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中文摘要:
目的：探讨在CroweⅢ型发育性髋关节发育不良全髋关节置换术中非骨水泥臼杯适度高位安放和解剖位安放的临床疗效对比。
方法：回顾性分析2010年1月至2015年12月，46例（58髋） CroweⅢ型髋关节发育不良患者全髋关节置换术中臼杯高位安放（高位安放组），选择2004年1月至2009年12月行全髋关节置换中自体股骨头结构性植骨髋臼解剖位重建的CroweⅢ髋关节发育不良患者（解剖位安放组）20例（28髋）作为对照。高位安放组男6例（8髋），女40例（50髋）；年龄40~70（54.3±7.6）岁。解剖位安放组男4例（5髋），女16例（23髋）；年龄42~68（53.0±7.1）岁。比较两组手术时间及出血量，术后Harris评分、步态、Trendelanburg征及下肢长度差，影像学测量结果，假体生存率有无差异。
结果：高位安放组手术时间为（75.1±13.3） min，出血量为（108.4±47.1） ml；解剖位安放组手术时间为（107.7±17.1） min，出血量（210.0±58.6） ml；高位安放组的手术时间和出血量均小于解剖位安放组。术后2年随访时高位安放组HHS评分为92.3±3.7，解剖位安放组Harris评分为91.4±3.6，两组差异无统计学意义。双下肢长度高位安放组（3.8±2.1） mm，解剖位安放组（3.5±1.6） mm，两组差异无统计学意义。术后高位安放组旋转中心距泪滴连线的垂直距离（31.6±7.8） mm，解剖位安放组（19.3±7.4） mm，解剖位安放组小于高位安放组；水平距离高位安放组（30.1±7.7） mm与解剖位安放组（29.4±7.5） mm比较差异无统计学意义。两组假体生存率差异无统计学意义。随访期间所有患者步态良好，无外展肌效力不足导致的跛行或Trendelanburg征阳性。
结论：CroweⅢ型发育性髋关节发育不良全髋关节置换术中生物型臼杯适当高位并内移安放术后短期随访患者功能好、假体生存率高，因此臼杯高位安放是CroweⅢ型发育性髋关节发育不良髋臼重建的一种有效方法。 |
| 【关键词】关节成形术,置换,髋 骨疾病,发育性 髋臼 髋假体 |
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| Acetabular cup position on high hip and anatomical position in total hip arthroplasty for Crowe Ⅲ developmental dysplasia of hip joint |
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ABSTRACT
Objective:To evaluate clinical outcomes of acetabular cup position on high hip and anatomical position in total hip arthroplasty for Crowe Ⅲ developmental dysplasia of hip joint.
Methods:Forty-six patients(58 hips) treated with high hip center THA from January 2010 to December 2015,including 6 males (8 hips) and 40 females(50 hips) aged from 40 to 70 years old with an average of(54.3±7.6) years old. While 20 patients(28 hips) treated with anatomical position in THA from January 2004 and December 2009 were analyzed as control,including 4 males (5 hips) and 16 females (23 hips),aged from 42 to 68 years old with an average of (53.0±7.1) years old. Operative time,blood loss,Harris score (HHS),gait analysis,Trendelanburg signal,imaging examinations and prosthesis survivorship were compared between two groups.
Results:Operative time and blood loss in high hip group(75.1±13.3) min and(108.4±47.1) ml respectively were lower than that of in anatomical position group(107.7±17.1) min and(201.0±58.6) ml respectively. There was no statistical difference in HSS score at 2 years after operation in high hip group(92.3±3.7) scores and anatomical position group(91.4±3.6) scores. No obvious meaning in lower limb differences in high hip group (3.8±2.1) mm and anatomical position group (3.5±1.6) mm. The vertical distance between center of rotation to teardrop in high hip group(31.6±7.8) mm was higher than that of anatomical group(19.3±7.4) mm;while there was no significant differences in horizontal distance between high hip group (30.1±7.7) mm and anatomical group(29.4±7.5) mm. There was no statistical significance in prosthesis survivorship. The gait was good without lameness and positive features of Trendelanburg signal caused by insufficient of abductor.
Conclusion:For Crowe Ⅲ DDH,a high hip center cementless cup without bone graft is a liable method with good function and high rate of prosthesis survivorship. And satisfying short-term clinical and radiographic results could be achieved by this method. |
| KEY WORDS Arthroplasty replacement,hip Bone diseases,development Acetabulum Hip prosthesis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王振江,强晓军,刘涛.CroweⅢ型发育性髋关节发育不良全髋关节置换术中臼杯高位和解剖位安放的临床疗效对比分析[J].中国骨伤,2018,31(10):922~926 |
| 英文格式: | WANG Zhen-jiang,QIANG Xiao-jun,LIU Tao.Acetabular cup position on high hip and anatomical position in total hip arthroplasty for Crowe Ⅲ developmental dysplasia of hip joint[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(10):922~926 |
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