摘要
目的评估人工全髋关节置换术（total hip arthroplasty，THA）治疗髋关节骨性强直的效果。方法自1987年8月～1998年2月，36例（38髋）行转换THA，平均术前融合时间20年1个月；平均随访8年11个月。结果Harris评分由（68．7±7．2）分提高到（87±6．1）分；髋关节总活动度增加180．7°±14．5°。关节疼痛缓解率为93．3％；平均肢体短缩由4．1cm降到1．6cm；人工关节存活率为86．8％。X线片示髋臼骨溶解6例，髋臼杯松动2例，股骨骨溶解4例，股骨柄松动1例。结论骨性强直的髋关节转换THA，可以缓解周围关节疼痛、增加髋关节的活动度、改善双下肢不等长和矫正髋关节畸形，提高生活质量。髋关节功能与臀中肌力量的恢复直接关联。
Objective To evaluate the clinical and radiographic results of conversion total hip arthroplasty in the bony fused hip. Methods Between August 1987 and February 1998, 38 hips underwent conversion of the fused hip to the total hip arthroplasty （THA）. The average age at the time of operation and follow up period were 38 years old and eight years and eleven months, respectively. The average period of fusion was twenty years and one month. Results The average postoperative Harris hip score was improved from 68.7 ± 7.2 points preoperatively to 87 ± 6.1 points postoperatively. The total range of motion of hip improved mean 180.7° - 14.5°. The rate of joint pain relief was 93.3 %. The discrepancy of lower extremities was reduced from mean 4.1 cm to 1.6 cm. The survival rate of implants was 86.8 % （33 ＇of 38 hips）. In radiographic photos, acetabutar osteolysis, femur osteotysis, metal stem loosening were observed in 6 hips, 2 hips, 4 hips and 1 hip respectively. Conclusion The conversion THA could provide pain relief, correct the leg discrepancy and the fixed deformity, and obtain the hip joint motion. The function of hip joint is related to the recovery of strength of the gluteus medius muscle postoperatively.
出处
《中国骨与关节损伤杂志》
2006年第8期593-596,共4页
Chinese Journal of Bone and Joint Injury
