髋臼有限高位重建对Crowe Ⅱ型及Ⅲ型髋关节发育不良术后中长期疗效的影响OA
Mid-to long-term outcomes of total hip arthroplasty with limited high hip center acetabular reconstruction for Crowe Ⅱ and Ⅲ developmental dysplasia of the hip
目的:探讨髋臼有限高位重建全髋关节置换治疗继发骨关节炎的Crowe Ⅱ、Ⅲ型髋关节发育不良(devel-opmental dysplasia of the hip,DDH)的中长期临床疗效.方法:回顾分析2013年1月至2018年12月应用髋臼有限高位重建全髋关节置换术治疗的Crowe Ⅱ、Ⅲ型髋关节发育不良29例(31髋)患者的临床资料,男8例,女21例;年龄45～71(53.61±8.75)岁;Crowe Ⅱ型 22 髋,Crowe Ⅲ型9髋.对疼痛视觉模拟评分(visual analogue scale,VAS)、Harris髋关节评分(Harris hip score,HHS)、双下肢相对长度差及放射学检查结果变化进行评价,时记录治疗及随访期间并发症的发生情况.结果:所有患者获得随访,时间67～135(91.04±20.75)个月.术前HHS评分(47.81±9.46)分、VAS(6.66±1.00)分、双下肢相对长度差(16.97±6.69)mm,旋转中心与泪滴连线的垂直距离(29.30±3.95)mm,旋转中心与泪滴的水平距离(39.79±4.75)mm,股骨偏心距(26.73±5.61)mm.术后髋关节功能显著改善,末次随访HHS评分为(91.16±3.26)分、VAS下降至(1.56±0.76)分,双下肢相对长度差(4.25±2.51)mm,旋转中心与泪滴连线的垂直距离(27.99±1.64)mm,旋转中心与泪滴的水平距离(28.67±2.20)mm,股骨偏心距(37.93±5.24)mm,与术前比较,差异均有统计学意义(P＜0.01).术后随访所有患者未出现Trendelenburg征、假体松动、关节脱位,末次随访无异常步态.结论:髋臼有限高位重建全髋关节置换治疗继发骨关节炎的Crowe Ⅱ、Ⅲ型髋关节发育不良的中长期临床效果满意.
Objective To investigate the medium and long-term clinical efficacy of total hip arthroplasty(THA)with lim-ited high acetabular reconstruction in the treatment of Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH)compli-cated with secondary osteoarthritis.Methods The clinical data of 29 patients(31 hips)with Crowe type Ⅱ and Ⅲ DDH who underwent THA with limited high acetabular reconstruction from January 2013 to December 2018 were retrospectively ana-lyzed.Among them,there were 22 hips with Crowe type Ⅱ and 9 hips with Crowe type Ⅲ;there were 8 male patients and 21 fe-male patients,aged from 45 to 71 years old with an average of(53.61±8.75)years old.The visual analogue scale(VAS),Harris hip score(HHS),relative length difference of the lower limbs,and changes in radiological examination results were used for e-valuation.Meanwhile,the occurrence of complications during treatment and follow-up was recorded.Results The follow-up du-ration ranged from 67 to 135 months,with an average of(91.04±20.75)months.Preoperatively,the HHS was(47.81±9.46)points,the VAS score was(6.66±1.00)points,the relative length difference of the lower limbs was(16.97±6.69)mm,the ver-tical distance between the rotational center and the teardrop line was(29.30±3.95)mm,the horizontal distance between the ro-tational center and the teardrop was(39.79±4.75)mm,and the femoral offset was(26.73±5.61)mm.Postoperatively,hip joint function was significantly improved.At the last follow-up,the HHS was(91.16±3.26)points,the VAS score decreased to(1.56±0.76)points,the relative length difference of the lower limbs was(4.25±2.51)mm,the vertical distance between the ro-tational center and the teardrop line was(27.99±1.64)mm,the horizontal distance between the rotational center and the teardrop was(28.67±2.20)mm,and the femoral offset was(37.93±5.24)mm.All these indices showed statistically significant differences compared with the preoperative values(P＜0.01).During postoperative follow-up,none of the patients developed Trendelenburg sign,prosthesis loosening,or joint dislocation,and no abnormal gait was observed at the final follow-up.Con-clusion THA with limited high acetabular reconstruction achieves satisfactory medium-and long-term clinical outcomes in the treatment of Crowe type Ⅱ and Ⅲ DDH complicated with secondary osteoarthritis.
周建华;吴祖亮;胡锐明
广州中医药大学顺德医院,广东 顺德 528300广州中医药大学顺德医院,广东 顺德 528300广州中医药大学顺德医院,广东 顺德 528300
医药卫生
髋臼重建发育性髋关节发育不良全髋关节置换术骨关节炎
Acetabular reconstructionDevelopmental dysplasia of the hipTotal hip arthroplastyOsteoarthritis
《中国骨伤》 2026 (7)
704-709,6
佛山市"十四五"医学高水平重点专科建设项目(编号:FSGSP145103)佛山市"十四五"中医重点专科、专病建设项目(编号:ZDZKJS08)High-level Key Specialty Construction Project of Medicine During the 14th Five-Year Plan Period in Foshan City(No.FS-GSP145103)
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