摘要
目的探究采用单纯全髋关节置换术(THA)和THA+髋内收肌切断术(HAA)两种方案治疗晚期股骨头坏死合并髋外展受限,术后患者外展功能改善的差异,从而指导临床应用。方法回顾性收集2011年6月-2012年5月期间收治的74例股骨头坏死合并髋外展活动受限患者,其中38例行单纯THA,36例行THA+HAA。统计患者术前、术后1周、术后12个月髋外展活动度、Harris评分。采用SPSS 19.0软件对患者术后1周和12个月髋外展活动增加度和髋关节Harris评分的增加值进行统计学分析。结果两组患者伤口均Ⅰ期愈合,THA+HAA组2例患者术后出现阴囊轻度肿胀,治疗好转后出院。术后1周,THA+HAA组与THA组患者髋关节被动外展角度分别增加(32.1±2.8)、(19.7±3.3)°,髋关节Harris评分分别增加(45.8±2.8)、(40.9±2.3)分;术后12个月,THA+HAA组与THA组的髋关节主动外展角度分别增加(32.2±0.9)、(26.8±2.8)°,髋关节Harris评分分别增加(52.7±7.2)、(49.4±4.4)分;以上组间比较差异均有统计学意义(P<0.05)。结论对于晚期股骨头坏死合并髋关节内收畸形较为严重的患者,行THA同时切断内收肌群止点能有效改善髋外展功能受限,进而提高患者术后生活质量以及满意度。
Objective To explore the therapeutic effect of total hip arthroplasty（THA） and hip adductor amputation（HAA） in the surgical treatment of osteonecrosis of femoral head. Methods A total of 74 patients with osteonecrosis of femoral head with hip adduction deformity were included between June 2011 and May 2012. Among them, 38 patients had undergone THA, and 36 patients had undergone THA＋HAA. Statistics about hip abductor function and Harris scores before and 1 week and 12 months after the surgery were recorded. SPSS 19.0 was used for statistical analysis. Results The patients＇ wounds had the Ⅰ-stage healing in both of the two groups. Two patients had scrotum swelling in THA＋HAA group, who left the hospital after treating. One week after the surgery, the hip passive abduction angles increased（32.1±2.8） and（19.7±3.3）°, respectively in the THA＋HAA group and THA group, while the Harris hip score increased 45.8±2.8 and 40.9±2.3, respectively; 12 months postoperatively, the hip passive abduction angles increased（32.2±0.9） and（26.8±2.8）°, respectively in the THA＋HAA group and THA group, while the Harris hip score increased 52.7±7.2 and 49.4±4.4, respectively. The above comparative differences was statistically significant（P〈 0.05）. Conclusion The surgical method of adductor amputation can improve the range of motion of the hip, raise the quality of life of the patients with osteonecrosis of the femoral head after the surgery.
出处
《华西医学》
CAS
2015年第11期2046-2049,共4页
West China Medical Journal
关键词
全髋关节置换术
内收肌切断术
关节活动度
疗效
Total hip arthroplasty
Adductor amputation
Range of the motion
Therapeutic effect
