实用骨科杂志
實用骨科雜誌
실용골과잡지
JOURNAL OF PRACTICAL ORTHOPEDICS
2014年
8期
701-703,768
,共4页
髋臼内陷症%人工全髋关节置换%髋臼重建
髖臼內陷癥%人工全髖關節置換%髖臼重建
관구내함증%인공전관관절치환%관구중건
protrusio acetabuli%total hip arthroplasty%acetabular reconstruction
目的:探讨人工全髋关节置换术中髋臼内陷的处理方法及早期疗效。方法2006年7月至2012年12月,收治继发性髋臼内陷症21例28髋,男12例17髋,女9例11髋;年龄26~68岁,平均56.3岁;原发疾病:类风湿关节炎9例14髋,强直性脊柱炎6例8髋,感染4例4髋(结核和化脓性关节炎各2例2髋),髋臼骨折畸形愈合2例2髋;轻度髋臼内陷6髋、中度髋臼内陷12髋、重度髋臼内陷10髋。患者均行人工全髋关节置换,术中单纯植入生物型臼杯6髋,打压植骨后直接植入生物型臼杯18髋,直接植入骨水泥杯2髋,打压植骨后骨水泥杯固定2髋。结果术后21例28髋切口均一期愈合,无感染及下肢深静脉血栓形成等并发症发生。患者均获随访,随访时间12~78个月,平均42个月。末次随访时,髋关节 Harris 评分为(87±4.1)分,术前 Harris 髋关节评分平均(45±3.3)分,较术前有显著差异,优22髋,良6髋,优良率100%。臼杯平均外翻角(42±3.5)°。植骨均骨性融合,无臼杯再次内陷及松动。髋关节活动度增加:屈曲增加(64.3±4.5)°,外展增加(20.5±3.5)°,内旋增加(16.5±2.5)°,外旋增加(19±2.5)°。末次随访时 X 线片显示所有假体均获得骨性稳定。术前股骨头内陷3~30 mm,平均13 mm;术后股骨头内陷0~5 mm,平均2 mm。人工股骨头旋转中心外移3~28 mm,平均10.5 mm。假体位置良好,无松动、下沉,植骨与髋臼融合,无髋臼再次内陷。结论人工全髋关节置换治疗髋臼内陷时,恢复患髋股骨偏心距及髋臼旋转中心,可获满意早期疗效。
目的:探討人工全髖關節置換術中髖臼內陷的處理方法及早期療效。方法2006年7月至2012年12月,收治繼髮性髖臼內陷癥21例28髖,男12例17髖,女9例11髖;年齡26~68歲,平均56.3歲;原髮疾病:類風濕關節炎9例14髖,彊直性脊柱炎6例8髖,感染4例4髖(結覈和化膿性關節炎各2例2髖),髖臼骨摺畸形愈閤2例2髖;輕度髖臼內陷6髖、中度髖臼內陷12髖、重度髖臼內陷10髖。患者均行人工全髖關節置換,術中單純植入生物型臼杯6髖,打壓植骨後直接植入生物型臼杯18髖,直接植入骨水泥杯2髖,打壓植骨後骨水泥杯固定2髖。結果術後21例28髖切口均一期愈閤,無感染及下肢深靜脈血栓形成等併髮癥髮生。患者均穫隨訪,隨訪時間12~78箇月,平均42箇月。末次隨訪時,髖關節 Harris 評分為(87±4.1)分,術前 Harris 髖關節評分平均(45±3.3)分,較術前有顯著差異,優22髖,良6髖,優良率100%。臼杯平均外翻角(42±3.5)°。植骨均骨性融閤,無臼杯再次內陷及鬆動。髖關節活動度增加:屈麯增加(64.3±4.5)°,外展增加(20.5±3.5)°,內鏇增加(16.5±2.5)°,外鏇增加(19±2.5)°。末次隨訪時 X 線片顯示所有假體均穫得骨性穩定。術前股骨頭內陷3~30 mm,平均13 mm;術後股骨頭內陷0~5 mm,平均2 mm。人工股骨頭鏇轉中心外移3~28 mm,平均10.5 mm。假體位置良好,無鬆動、下沉,植骨與髖臼融閤,無髖臼再次內陷。結論人工全髖關節置換治療髖臼內陷時,恢複患髖股骨偏心距及髖臼鏇轉中心,可穫滿意早期療效。
목적:탐토인공전관관절치환술중관구내함적처리방법급조기료효。방법2006년7월지2012년12월,수치계발성관구내함증21례28관,남12례17관,녀9례11관;년령26~68세,평균56.3세;원발질병:류풍습관절염9례14관,강직성척주염6례8관,감염4례4관(결핵화화농성관절염각2례2관),관구골절기형유합2례2관;경도관구내함6관、중도관구내함12관、중도관구내함10관。환자균행인공전관관절치환,술중단순식입생물형구배6관,타압식골후직접식입생물형구배18관,직접식입골수니배2관,타압식골후골수니배고정2관。결과술후21례28관절구균일기유합,무감염급하지심정맥혈전형성등병발증발생。환자균획수방,수방시간12~78개월,평균42개월。말차수방시,관관절 Harris 평분위(87±4.1)분,술전 Harris 관관절평분평균(45±3.3)분,교술전유현저차이,우22관,량6관,우량솔100%。구배평균외번각(42±3.5)°。식골균골성융합,무구배재차내함급송동。관관절활동도증가:굴곡증가(64.3±4.5)°,외전증가(20.5±3.5)°,내선증가(16.5±2.5)°,외선증가(19±2.5)°。말차수방시 X 선편현시소유가체균획득골성은정。술전고골두내함3~30 mm,평균13 mm;술후고골두내함0~5 mm,평균2 mm。인공고골두선전중심외이3~28 mm,평균10.5 mm。가체위치량호,무송동、하침,식골여관구융합,무관구재차내함。결론인공전관관절치환치료관구내함시,회복환관고골편심거급관구선전중심,가획만의조기료효。
Objective To evaluate the result of total hip arthroplasty in the treatment of protrusio acetabuli. Methods From 2006. 7 to 2012. 12,21 cases(28 hips)of protrusio acetabuli were treated,including 12 males and 9 females with an av-erage age of 56. 3years(range,26 ~ 68years). The preoperative Harris score was 45 ± 3. 3,there were 6 cases of mild,12 mod-erate cases,and 10 severe cases. All patients received total hip arthroplasty with recovery of femoral off set and acetabular cen-ter of rotation. Results All incisions healed without complication of infection,deep venous thrombosis,or nerve injury. All pa-tients were followed up 12 ~ 78 months with an average of 42 months. The Harris score at last follow-up was 87 ± 4. 1,showing significant difference when compared with preoperative score. The X-ray films showed that no prosthesis loosening or subsid-ence was observed,and bone graft healed with no sign of re-protrusion. Conclusion In treatment of protrusio acetabuli,total hip arthroplasty with recovery the femoral off set and acetabular center of rotation and provide satisfactory early result.