中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
22期
4144-4151
,共8页
骨关节植入物%骨与关节临床实践%类风湿性关节炎%髋关节置换%髋臼内陷%自体骨移植%髋关节假体%生物型假体%影像学评估%关节活动度%Harris评分%生物学固定%稳定性%Sotel o-Garza分级%Charnley分级
骨關節植入物%骨與關節臨床實踐%類風濕性關節炎%髖關節置換%髖臼內陷%自體骨移植%髖關節假體%生物型假體%影像學評估%關節活動度%Harris評分%生物學固定%穩定性%Sotel o-Garza分級%Charnley分級
골관절식입물%골여관절림상실천%류풍습성관절염%관관절치환%관구내함%자체골이식%관관절가체%생물형가체%영상학평고%관절활동도%Harris평분%생물학고정%은정성%Sotel o-Garza분급%Charnley분급
背景:类风湿性关节炎导致的髋臼内陷,髋臼运动中心重建和髋关节功能重建是人工全髋置换的两大技术难点.目的:探讨类风湿性关节炎继发髋臼内陷时行的髋关节置换的效果.方法:纳入治类风湿性关节炎累及髋关节造成髋臼内陷的患者16例(22髋)行全髋关节置换,其中男5例8髋,女11例14髋.所有患者置换过程中均行不同程度植骨,置换后随访28-94个月,平均50个月,行髋关节X射线进行影像学评估,关节活动度、Harris评分进行临床疗效评估.结果与结论:至末次随访,所有患者获得影像学上假体良好稳定,假体周围无明显透亮线,移植骨稳定, Harris 评分由置换前42.4±8.6,上升为87.5±5.6,关节活动度中屈曲由置换前(45.2±5.5)°,提高为(95.6±5.8)°,外展由(15.2±8.5)°,提高至(32.6±6.6)°.说明类风湿性关节炎继发髋臼内陷,进行全髋关节置换时,根据骨缺损情况结合自体骨移植,能有效恢复髋关节中心,重建髋关节功能.
揹景:類風濕性關節炎導緻的髖臼內陷,髖臼運動中心重建和髖關節功能重建是人工全髖置換的兩大技術難點.目的:探討類風濕性關節炎繼髮髖臼內陷時行的髖關節置換的效果.方法:納入治類風濕性關節炎纍及髖關節造成髖臼內陷的患者16例(22髖)行全髖關節置換,其中男5例8髖,女11例14髖.所有患者置換過程中均行不同程度植骨,置換後隨訪28-94箇月,平均50箇月,行髖關節X射線進行影像學評估,關節活動度、Harris評分進行臨床療效評估.結果與結論:至末次隨訪,所有患者穫得影像學上假體良好穩定,假體週圍無明顯透亮線,移植骨穩定, Harris 評分由置換前42.4±8.6,上升為87.5±5.6,關節活動度中屈麯由置換前(45.2±5.5)°,提高為(95.6±5.8)°,外展由(15.2±8.5)°,提高至(32.6±6.6)°.說明類風濕性關節炎繼髮髖臼內陷,進行全髖關節置換時,根據骨缺損情況結閤自體骨移植,能有效恢複髖關節中心,重建髖關節功能.
배경:류풍습성관절염도치적관구내함,관구운동중심중건화관관절공능중건시인공전관치환적량대기술난점.목적:탐토류풍습성관절염계발관구내함시행적관관절치환적효과.방법:납입치류풍습성관절염루급관관절조성관구내함적환자16례(22관)행전관관절치환,기중남5례8관,녀11례14관.소유환자치환과정중균행불동정도식골,치환후수방28-94개월,평균50개월,행관관절X사선진행영상학평고,관절활동도、Harris평분진행림상료효평고.결과여결론:지말차수방,소유환자획득영상학상가체량호은정,가체주위무명현투량선,이식골은정, Harris 평분유치환전42.4±8.6,상승위87.5±5.6,관절활동도중굴곡유치환전(45.2±5.5)°,제고위(95.6±5.8)°,외전유(15.2±8.5)°,제고지(32.6±6.6)°.설명류풍습성관절염계발관구내함,진행전관관절치환시,근거골결손정황결합자체골이식,능유효회복관관절중심,중건관관절공능.
@@@@BACKGROUND: The rheumatoid arthritis can induce acetabular protrusion, and the reconstruction of the movement center and hip function are the two difficulties for total hip arthroplasty. OBJECTIVE: To discuss the clinical efficacy of total hip arthroplasty for the treatment of rheumatoid arthritis induced acetabular protrusion. METHODS: Twenty-two hips in 16 patients with rheumatoid arthritis induced acetabular protrusion were involved, including five male patients with 8 hips and 11 female patients with 14 hips. They all received bone graft during total hip arthroplasty. All the patients were fol owed-up for 28-94 months, 50 months in average, and then imaging assessment was performed with hip X-ray films. The range of motion and the Harris score were used to evaluate the clinical efficacy. RESULTS AND CONCLUSION: Up to the final fol ow-up, al patients got prosthesis stability and stable bone graft, and there was no obvious radiolucent line around the prosthesis. The Harris score was increased from (42.4±8.6) before replacement to (87.5±5.6) after replacement, and the inflection angle of range of motion was increased from (45.2±5.5)° to (95.6±5.8)°, the abduction angle increased from (15.2±8.5)° to (32.6±6.6)°. Total hip arthroplasty combined with autogenous bone graft for the treatment rheumatoid arthritis induced acetabular protrusion can effectively restore the hip center and reconstruct the hip function.
