摘要
[目的]探讨全髋关节置换术(THA)中使用非水泥髋臼假体处理髋臼内陷的适应证、手术技术以及术后疗效。[方法]从1998～2009年,共38人(46髋)伴有髋臼内陷的患者接受非骨水泥臼杯的全髋关节置换术,男34髋,女12髋,平均年龄45岁。其中14髋术中行自体骨移植,术后随访1～8年(平均3年)。回顾分析手术技术,使用Harris、Charnley评分标准进行临床疗效评估,用髋关节正侧位X线片进行影像学评估。[结果]平均Harris评分由术前的48.5分提高到末次随访的85.1分,平均Charley评分由9.1分提高到15.7分。术后股骨头中心位置较术前外移、下移。所有患者髋臼组件稳定,没有出现明确的假体松动、断裂、移位、脱位或移植骨的重吸收。[结论]使用非水泥臼杯的全髋关节置换术,根据骨缺损情况结合自体骨移植,能有效治疗各种程度的髋臼内陷,恢复髋臼旋转中心的解剖位置,短中期临床疗效满意。
[Objective] To discuss the operative techniques and evaluate the clinic and radiology outcomes of patients with protrusio acetabuli after cementless total hip arthroplasty.[Method]Forty-six hips in 38 patients with acetabular protrusion received cementless total hip arthroplasty from 1998 to 2009.Their average age was 45.0 years old.Fourteen hips received self-bone graft.The operative techniques were discussed,clinical results were evaluated with Harris and Charnley scores,and radiology outcomes were assessed with anterior-posterior and lateral X ray images.[Result] All patients were followed up for 1 to 8 years （mean,3 years）.The mean Harris scores increased from 48.5 preoperatively to 85.1 postoperatively.The mean Charnley scores increased from 9.1 to 15.7.The acetabular rotational center was moved laterally and downward after operation.All acetabular components were stable.There were no prosthesis loosening,fracture,transposition or graft bone resorption.[Conclusion]In young patients,cementless total hip arthroplasty,with self-bone graft in serious cases,appears to be a good method to deal with acetabular protrusion.This method can change the position of acetabular rotational center more anatomically and have satisfactory mid-term clinical results.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第4期289-291,共3页
Orthopedic Journal of China
关键词
髋臼内陷
全髋置换
非水泥臼杯
自体骨移植
acetabular protrusion
total hip arthroplasty
cementless cup
bone grafting
