【摘要】 目的评价强直性脊柱炎全髋关节置换术的效果，并对强直性脊柱炎全髋关节置换术中常见问题的处理进行探讨。方法通过对 98例 (112侧 )强直性脊柱炎患者全髋关节置换术后 1.5～ 8年 (平均 4.2年 )的随访，对手术前后关节疼痛、活动度、畸形矫正及患者整体功能的改善情况进行了对比研究。结果术后除 32侧髋关节轻度疼痛， 4侧髋关节明显疼痛外，其余关节均无疼痛。关节活动度由术前平均 37.5°改善为 69.5°。髋关节屈曲畸形由术前平均 38.2°改善为 5.7°。术后所有患者生活均可自理。术中及术后并发症包括：股骨假体穿破股骨上端皮质 4例，坐骨神经损伤 3例，早期脱位 2例，髋臼假体脱位 2例，股骨假体下沉 23例。结论全髋关节置换术是治疗强直性脊柱炎晚期的髋关节病变的一种重要而有效的方法。采用髋关节前外及外侧联合切口可有效地松解关节前方挛缩的软组织，矫正髋关节屈曲畸形。多关节受累应首选受累最严重的关节施术，第二次手术宜在第一次术后 3～ 6个月内完成。更多还原

【Abstract】 Objective To evaluate the efficacy of total hip replacement in patients with ankylosing spondylitis(AS) and to solve the problem often encountered during surgery. Methods One hundred and twelve hips of 98 patients with AS undergone total hip replacement were reviewed. The mean duration of follow up was 4.2 years(range, 1.5 to 8 years). The pre and postoperatively comparative study on pain, range of motion, correction of deformity and total function evaluation were conducted. Results Pain relief obtained in all but 4 hips. Mean range of motion was improved from 37.5° to 69.5° and the flexion deformity of the involved hip was corrected from mean 38.2° to 5.7°， all of the patients could take care of daily living by themselves. Complications included penetrating fracture of proximal femur in 4, sciatic nerve injury in 3, early dislocation of the hip in 2, disassociation of the acetabular component in 2 and sinking of the femoral stem in 23. Conclusion Total hip replacement is a very important and effective treatment of choice for patients with AS. The modified combination of anterolateral and lateral approach used by the authors facilitated release of contracture of the soft tissue anterior to the hip joint and correction of flexsion deformity of the hip. In case of multiple joint involvement, the surgery should be performed on the most severely involved one and the next surgery, if required, should be scheduled later within 3 to 6 months.更多还原