【作者】 赵赞栋； 王健； 肖军； 兰天； 李郅涵； 卢坤； 周亚鹏； 史占军；

【Author】 ZHAO Zan-dong;WANG Jian;XIAO Jun;Department of Orthopedic Surgery,Nanfang Hospital,Southern Medical University;

【机构】 南方医科大学南方医院关节与骨病外科；

【摘要】 [目的]研究全髋关节表面置换术中,单纯骨性关节炎及髋关节发育不良(DDH)对髋臼安装角度的影响及两组病例疗效比较。[方法]自2006年~2009年,我科共实施全髋表面关节置换术20人23髋,病因包括单纯骨性关节炎10髋及髋关节发育不良13髋。手术假体均采用金属对金属大直径表面置换假体,股骨侧骨水泥固定,髋臼侧生物型固定。[结果]所有患者均获得近期随访(6~36个月),随访包括临床评估和放射学评估。两组患者术后Harris评分无明显统计学差异。无一发生术后脱位、股骨颈骨折等并发症。其中单纯骨性关节炎患者术后臼杯外展角25.6~56.0°(平均43.9±9.9°),平均髓臼覆盖率达95.8%。髋臼发育不良患者术后臼杯外展角22.4—69.3°(平均46.8±12.9°),髋臼覆盖率达84.3%。[结论]金属对金属大直径表面置换假体在治疗单纯骨性关节炎及髋关节发育不良早期临床疗效并无明显统计学差异。但是髋关节发育不良患者行髋关节表面置换术中,髋臼假体外展角离散度要明显高于单纯骨性关节炎组,其髋臼杯假体外展角度控制要难于单纯骨性关节炎。更多还原

【Abstract】 [Objective]To observe the early clinical result and thelocation and angle of acetabulum of the total hip resurfacing arthroplasty(THRA) in surgery of osteoarthritis of hip and developmental dysplasia of hip(DDH).[Methods]A retrospective study was carried out in twenty patients(twenty-three hips) dealt with THRA from 2006 to 2009,including ten cases of osteoarthritis and thirteen cases of DDH.All patients were implanted with metal-on-metal prostheses of large diameter.Femoral head was fixed with cement and the acetabular cup was biologically fixed.[Results]Totally twenty-three cases received the follow-up,with an average24 months(6 ~36months) after discharge.There was no signficiant statistical difference between the two groups in the harris score.Howevers,there were numerous disparities between the two groups in the anatomy parameter of acetabular prosthesis.In group of osteoarthritis,the average acetabular cup abduction angle was 43.9 ±9.9(25.6~56.0) degrees and the average acetabular fraction of coverage was 95.8%.In group of DDH,the average acetabular cup abduction angle was 46.8 ± 12.9(22.4 ~ 69.3) degrees and the average acetabular fraction of coverage was 84.3%.No complications such as dislocation or fracture were found.[Conclusion]There is no statistical difference in the early clinical result of THRA between osteoarthritis and DDH.Meanwhile,because of the mismatching of the acetabular cup components due to malformation of acetabulum in DDH,it is more difficult to install the acetabulum prosthesis in a good angle and location.更多还原