| 高髋关节中心技术在CroweⅡ型和Ⅲ型发育性髋关节发育不良并重度髋关节炎全髋关节置换术中的应用 |
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Received:November 20, 2022
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| 作者 | Author | 单位 | Unit | E-Mail |
| 胡浩 |
HU Hao |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
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| 杨俊忠 |
YANG Jun-zhong |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
phineesm205@21cn.com |
| 李亮 |
LI Liang |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
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| 黄传文 |
HUANG Chuan-wen |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
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| 万玲玲 |
WANG Ling-lin |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
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| 易莉艳 |
YI Li-yan |
武汉市江夏区第一人民医院协和江南医院骨科, 湖北 武汉 430299 |
Department of Orthopaedics, the First People's Hospital of Jiangxia District, Union Medical College Jiangnan Hospital, Wuhan 430299, Hubei, China |
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| 期刊信息：《中国骨伤》2024年37卷，第2期，第166-172页 |
| DOI：10.12200/j.issn.1003-0034.20220382 |
| 基金项目:武汉市卫生和计划生育委员会科研项目（编号：WX19C26） |
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目的：探讨高髋关节中心技术全髋关节置换术（total hip arthroplasty，THA）治疗Crowe Ⅱ、Ⅲ型发育性髋关节发育不良（developmental dysplasia of hip，DDH）并重度髋关节炎（hip osteoarthritis，HOA）的临床疗效。
方法：2018年1月至2020年1月收治CroweⅡ、Ⅲ型DDH并重度HOA患者74例，37例行解剖型髋关节中心重建为对照组，其中男7例，女30例，年龄42~65（58.40±4.98）岁，身体质量指数（body mass index，BMI）18~29（23.02±2.21） kg·m-2。37例行高髋关节中心技术重建为研究组，其中男5例，女32例，年龄41~65（57.31±5.42）岁，BMI 18~29（23.14±2.07） kg·m-2。患者术前表现髋关节疼痛、功能及关节活动度受限、步态不稳等。比较两组围术期指标，术前及术后3、6、12个月分别评估患者髋关节功能、平衡功能及步态情况，术前及术后12个月测量双下肢长度差、旋转中心水平距离、旋转中心垂直距离、股骨偏心距。
结果：术后随访12个月，研究组失访1例，对照组失访2例。研究组手术时间短于对照组，术中出血量少于对照组（P<0.05）。术后3、6个月研究组Harris评分、Berg平衡量表（Berg balance scale，BBS）评分、步速、步频、单步长大于对照组（P<0.05），术后12个月以上指标组间比较，差异无统计学意义（P>0.05）；术后12个月，研究组旋转中心垂直距离大于对照组（P<0.05），两组双下肢长度差、旋转中心水平距离、股骨偏心距比较，差异无统计学意义（P>0.05）；两组均未出现并发症。
结论：两种髋关节中心重建方式应用于DDH并重度HOA患者THA远期效果相当，安全性良好，且高髋关节中心技术重建可缩短手术时间，减少术中出血量，同时在早期恢复患者髋关节功能、平衡功能及步行功能方面具有一定优势。 |
| [关键词]:高髋关节中心技术 发育性髋关节发育不良 重度 髋关节炎 全髋关节置换术 |
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| Application of high hip center technique in total hip arthroplasty in patients with Crowe typeⅡand Ⅲ developmental dysplasia of hip and severe hip osteoarthritis |
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Abstract:
Objective To explore the clinical efficacy of high hip center technique total hip arthroplasty (THA) for Crowe Ⅱand Ⅲ developmental dysplasia of hip (DDH) and severe hip osteoarthritis (HOA).
Methods From January 2018 to January 2020, 74 patients with Crowe typeⅡand Ⅲ DDH and severe HOA were admitted, and 37 cases of anatomical hip center reconstruction were taken as control group, including 7 males and 30 females, aged from 42 to 65 years old with an average of (58.40±4.98) years old, body mass index (BMI) ranged from 18 to 29 kg·m-2 with an average of (23.02±2.21) kg·m-2. Thirty-seven routine high hip center technical reconstruction were performed as study group, including 5 males and 32 females, aged from 41 to 65 years old with an average of (57.31±5.42) years old, BMI ranged from 18 to 29 kg·m-2 with an average of (23.14±2.07) kg·m-2. The patients presented with hip pain, limited function and range of motion, and gait instability before surgery. All patients underwent THA, the control group underwent intraoperative anatomical hip center reconstruction, and the study group underwent intraoperative high hip joint reconstruction. The perioperative indicators of the two groups were compared. The hip joint function, balance function and gait of the patients were evaluated before surgery, 3 months, 6 months, and 12 months after surgery. The length difference of both lower limbs, horizontal distance of rotation center, vertical distance of rotation center and femoral eccentricity were measured before operation and 1 year after operation. The incidence of complications in the two groups during the operation and postoperative follow-up was counted.
Results The operation time of the study group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group (P<0.05). After 12-months follow-up, 1 was lost to followvup in study group and 2 were lost to follow-up in control group. The Harris scores and Berg balance scale(BBS), pace, stride frequency and single step length in the study group were higher than those in the control group at 3 months and 6 months after operation (P<0.05);there was no statistically significant difference between the two groups in the indexes 12 months after operation (P>0.05). The vertical distance of the center of rotation of the study group was greater than that of the control group 12 months after operation (P<0.05), and there was no significant difference in the length difference of the lower limbs, the horizontal distance of the center of rotation, and the femoral eccentricity between two groups (P>0.05). There were no complications in either group.
Conclusion The long-term effects of THA in patients with DDH and severe HOA were similar between the two central hip reconstruction methods, and the safety was good, and the high hip central reconstruction technique could shorten the operation time and reduce the amount of intraoperative blood loss.At the same time, it has certain advantages in early recovery of hip joint function, balance function and walking function of patients. |
| KEYWORDS:High hip center technique Developmental dysplasia of hip Severe Hip osteoarthritis Total hip arthroplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡浩,杨俊忠,李亮,黄传文,万玲玲,易莉艳.高髋关节中心技术在CroweⅡ型和Ⅲ型发育性髋关节发育不良并重度髋关节炎全髋关节置换术中的应用[J].中国骨伤,2024,37(2):166~172 |
| 英文格式: | HU Hao,YANG Jun-zhong,LI Liang,HUANG Chuan-wen,WANG Ling-lin,YI Li-yan.Application of high hip center technique in total hip arthroplasty in patients with Crowe typeⅡand Ⅲ developmental dysplasia of hip and severe hip osteoarthritis[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(2):166~172 |
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