摘要
目的探讨改良髋臼中心化技术在人工全髋关节置换术（totalhiparthroplasty，THA）中对纠正双下肢不等长的应用价值。方法2001年6月-2012年1月，收治147例髋关节旋转中心异常患者，其中68例行常规THA（对照组），79例THA术中采用以卵圆窝为导向的髋臼中心化技术重建髋臼（试验组）。两组患者性别、年龄、侧别、病因、术前双下肢相对和绝对长度差值、髋关节旋转中心相关测量指标、Harris评分等一般资料比较，差异均无统计学意义（P〉0．05），具有可比性。两组手术前后采用Harris评分评定髋关节功能，用软尺测量双下肢相对长度差值，在x线片上用软件测量双下肢绝对长度差值以及实际旋转中心与真实旋转中心的水平距离和垂直距离，并进行统计学比较。结果两组患者均获随访，试验组随访时间8～26个月，平均8．3个月；对照组6～33个月，平均9．7个月。术后两组各1例发生坐骨神经损伤，试验组3例、对照组4例发生下肢深静脉血栓形成，对照组髋关节脱位2例，其余患者无相关并发症。术后6个月试验组双下肢相对长度差值以及Harris评分均优于对照组（P〈0．05）；组内与术前比较，差异亦有统计学意义（P〈0．05）。术后即刻x线片测量示，试验组实际旋转中心与真实旋转中心水平距离和垂直距离均优于对照组（P〈0．05）；组内两检测指标与术前比较，差异亦有统计学意义（P〈0．05）。术后6个月试验组双下肢绝对长度差值优于对照组（P〈O．005）；组内与术前比较，差异亦有统计学意义（P〈0．05）。结论THA术中应用以卵圆窝为导向的髋臼中心化技术可明显纠正异常髋关节旋转中心，有效纠正双下肢相对和绝对长度差异，提高患者生活质量。
Objective To investigate the application value of acetabular centralization technology for correction of leg-length inequality in total hip arthroplasty （THA）. Methods Between June 2001 and January 2012, 147 cases of abnormal acetabular center were treated. Of them, 68 cases underwent routine THA （control group）, and 79 cases underwent acetabular reconstruction by fossae ovalis oriented centralized technology in THA （test group）. There was no significant difference in gender, age, side, pathogeny, acetabular rotation center indexs, difference of relative and absolute leg-length, and Harris score between 2 groups before operation （P 〉 0.05）. The hip joint function was evaluated by Harris score; the difference of relative leg-length was measured by tape; the difference of absolute leg-length and the horizontal and vertical distances of actual and true rotation center were also measured on the X-ray films by software. Results The patients were followed up 8-26 months （mean, 8.3 months） in the test group, and 6-33 months （mean, 9.7 months） in the control group. Sciatic nerve injury occurred in 2 cases （1 in each group, respectively）, lower extremity deep venous thrombosis in 7 cases （3 in test group and 4 in control group）, and hip joint dislocation in 2 cases （control group）; the other patients had no related complications. The difference of relative leg- length and Harris score in test group were significantly better than in control group （P 〈 0.05）, and significant difference was also found when compared with preoperative one in 2 groups （P 〈 0.05）. The horizontal and vertical distances of actual and the true rotation center in test group was significantly better than those in control group at immediate after operation on the X-ray films （P 〈 0.05）; and significant differences were also found when compared with preoperative ones in 2 groups （P 〈 0.05）. At 6 months after operation, the absolute leg-length difference in test group was significantly better than that in control group （P 〈 0.05）; and significant difference was also found when compared with preoperative one in 2 groups （P 〈 0.05）. Conclusion Thefossae ovalis oriented acetabular centralized technology in THA can significantly correct abnormal hip center of rotation, thus reduce the relative and absolute leg-length inequality and improve the life quality of the patients.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2014年第2期213-217,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
四川省卫生厅科学研究项目(080426)~~
关键词
人工全髋关节置换术
髋臼中心化技术
双下肢不等长
Total hi p arthroplasty
Acetabular centralization technology
Leg-length inequality
