CAJ | 학술논문

目的探讨不同类型髋臼发育不良伴骨性关节炎的全髋关节置换手术策略.方法 1999年1月至2006年12月,对35例37髋因髋臼发育不良伴骨性关节炎患者行全髋关节置换术.术前Harris评分30～64分,平均45分.采用软组织彻底松解、原位髋臼、股骨不截骨的方法行全髋关节置换术.Crowe Ⅰ、Ⅱ型髋臼发育不良者,选用常规的非骨水泥压配型假体;CroweⅢ、Ⅳ型髋臼发育不良者,选用适当小号的、Zweym ü ller系统的非骨水泥双锥面螺旋臼和细而直的SL矩形股骨柄.结果所有患者切口均一期愈合,随访12～60个月,平均24个月,未出现关节脱位、假体周围骨折、股神经及坐骨神经损伤等并发症,无假体松动的临床和X线征象.术后Harris评分60～95分,平均85分.结论术前充分准备、术中彻底松解,一般能在真臼处放置髋臼假体,并恢复肢体长度.
목적 탐토불동류형관구발육불량반골성관절염적전관관절치환수술책략.방법 1999년1월지2006년12월,대35례37관인관구발육불량반골성관절염환자행전관관절치환술.술전Harris평분30～64분,평균45분.채용연조직철저송해、원위관구、고골불절골적방법행전관관절치환술.Crowe Ⅰ、Ⅱ형관구발육불량자,선용상규적비골수니압배형가체;CroweⅢ、Ⅳ형관구발육불량자,선용괄당소호적、Zweym ü ller계통적비골수니쌍추면라선구화세이직적SL구형고골병.결과 소유환자절구균일기유합,수방12～60개월,평균24개월,미출현관절탈위、가체주위골절、고신경급좌골신경손상등병발증,무가체송동적림상화X선정상.술후Harris평분60～95분,평균85분.결론 술전충분준비、술중철저송해,일반능재진구처방치관구가체,병회복지체장도.
Objective To investigate the experiences of total hip replacement in the treatment of different types of osteoarthritis secondary to acetabular dysplasia, and evaluate its effect. Methods From January 1999 to December 2006, 37 hips in 35 cases with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement were included in this study. Preoperative Harris score was 30-64 points, with an average score of 45 points. Undergoing total hip replacement with complete release, of soft tissue, original acetabular, and no femoral osteotomy. Crowe Ⅰ , Ⅱ-type acetabular dysplasia chose conventional cementless press-fit prosthesis;Crowe Ⅲ,Ⅳ-type,chose the appropriate trumpet,Zweymüller system cementless acetabular biconical spiral surface and thin and straight SL rectangular hip stems. Results The duration of follow-up ranged from 12 to 60 months (average 24 months). No case appeared dislocation, periprosthetic fractures, femoral nerve and sciatic nerve injury and other complications, no clinical and X-ray findings of prosthesis loosening occurred. Postoperative Harris score was 60-95 points, and average was 85 points. Conclusion Adequate preoperative preparation, intraoperative complete release, is the key of the treatment and restoration of limb length.