| 王江开,杨敏之,孔祥朋,等.组配式假体在Crowe Ⅰ、Ⅱ型发育性髋关节发育不良全髋关节置换术中的应用.骨科,2018,9(5): 365-370. |
| 组配式假体在Crowe Ⅰ、Ⅱ型发育性髋关节发育不良全髋关节置换术中的应用 |
| Total hip arthroplasty with modular prosthesis for Crowe Ⅰ and Ⅱ developmental dysplasia of the hip |
| 投稿时间：2018-06-20 |
| DOI：10.3969/j.issn.1674-8573.2018.05.006 |
| 中文关键词: 髋脱位，先天性 关节成形术，置换，髋 髋假体 股骨 假体设计 |
| 英文关键词: Hip dislocation, congenital Arthroplasty, replacement, hip Hip prosthesis Femur Prosthesis design |
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| 中文摘要: |
| 目的 探讨应用组配式假体行全髋关节置换术（total hip arthroplasty, THA）治疗CroweⅠ、Ⅱ型发育性髋关节发育不良（developmental dysplasia of the hip, DDH）的短期临床疗效。方法 回顾性分析2016年10月至2017年10月，中国人民解放军总医院骨关节科收治的40例单侧Crowe Ⅰ、Ⅱ型DDH病人的临床资料，其中男5例，女35例；年龄为（36.90±10.30）岁（19~51岁），股骨选用组配式假体，全部纳入组配式假体组。另选择既往40例术前设计采用普通锥形假体的单侧Crowe Ⅰ、Ⅱ型DDH病人作为对照组。比较两组病人的基本信息，术中及术后并发症发生情况，术前及术后6个月髋关节Harris功能评分，术后双下肢长度及偏心距差异等指标。结果 组配式假体组与对照组病人的术中股骨假体周围骨折发生率（5.0%比10.8%）、术后脱位率（2.5%比8.1%）、偏心距差异发生率（20.0%比37.8%）比较，差异均无统计学意义（χ2=0.276，P=0.600；χ2=0.353，P=0.553；χ2=2.997，P=0.083）。术后，组配式假体组的髋关节Harris功能评分较对照组高[（89.45±9.22）分比（84.69±8.77）分；t=2.077，P=0.041]，双下肢不等长发生率低（17.5%比43.2%；χ2=6.081，P=0.014）。结论 在Crowe Ⅰ、Ⅱ型DDH中，组配式假体比普通假体更易获得双下肢等长及更佳的关节功能。 |
| 英文摘要: |
| Objective To discuss the short-term clinical effect of total hip arthroplasty (THA) with modular prosthesis for Crowe Ⅰ and Ⅱ developmental dysplasia of the hip (DDH). Methods Between October 2016 and October 2017, 40 patients with unilateral Crowe Ⅰ or Crowe Ⅱ DDH which were treated with modular prosthesis in the General Hospital of the Chinese People's Liberation Army were retrospectively analyzed. There were 5 males and 35 females, aged (36.90±10.30) years (19-51 years), who were included in the modular prosthesis group. Forty patients with unilateral Crowe Ⅰ or Crowe Ⅱ DDH who had been designed with conventional conical prosthesis before operation were selected as control group. The demographic parameters, intraoperative and postoperative complications, preoperative and postoperative Harris score, Leg length discrepancy, and offset discrepancy of the two groups were evaluated. Results There was no significant difference in the intraoperative fracture incidence around the femoral prosthesis (5.0% vs. 10.8%), dislocation rate (2.5% vs. 8.1%), offset (20.0% vs. 37.8%) between modular prosthesis group and control group (χ2=0.276, P=0.600; χ2=0.353, P=0.553; χ2=2.997, P=0.083). The postoperative Harris score (89.45±9.22 vs. 84.69±8.77; t=2.077, P=0.041) and the leg length discrepancy (17.5% vs. 43.2%; χ2=6.081, P=0.014) between modular prosthesis group and control group had statistically significant differences. Conclusion Modular prosthesis compared with common prosthesis was more likely to gain equal leg length and higher Harris score when treating Crowe Ⅰ and Ⅱ DDH. In such patients, it is recommended to use a modular prosthesis to obtain better joint function of hip. |
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