摘要
目的探讨全髋关节置换术(total hip arthroplasty,THA)治疗髋关节感染导致的髋关节骨性融合患者的临床疗效。方法回顾分析 2010 年1月至 2018 年 12 月,18 例因髋关节感染导致骨性融合,在我院行 THA 患者的临床资料。男 10 例,女 8 例,平均年龄 40.1(19~64)岁,结核性感染 7 例,化脓性感染11 例,均为髋关节感染后关节骨性融合强直的患者。临床主要症状为:患者髋活动受限,不等长,跛行。均采用一期 THA,臼杯均安装于原臼处,臼杯骨量至少覆盖 70%。随访观察髋关节活动、患肢长度、并发症。采用髋关节 Harris 评分标准评定患肢功能。结果 8 例平均随访 4.1 年。1例术中股神经不全损伤,术后下肢深静脉血栓1例,术后假体周围感染1例,1 例术后 2 年死于心肌梗塞。患者髋关节功能较术前明显改善,双下肢长度的平均差值 0.6 cm。Harris 评分:术前(45.3±4.3)分提高至术后(84.3±6.3)分,差异有统计学意义(t=5.836,P=0.031)。结论对于髋关节感染导致关节融合强直的患者行 THA 可有效恢复髋关节功能,改善患者生活质量,术中需要仔细操作,减少并发症,可以获得满意的临床效果。
Objective To study the feasibility and clinical results of total hip arthroplasty in the treatment of hip infection combined with ankylosis. Methods Eighteen patients with hip infection and ankylosis underwent one-stage total hip arthroplasty from Jan 2010 to Dec 2018. There were 10 males and 8 females with an average age of 40.1 years (range: 19-64 years), including tuberculous infection in 7 patients and pyogenic infection in 11 patients. Main clinical symptoms: limited hip activity, unequal length, limp. All acetabular cups located in the original places, and the bone mass was covered at least 70%. Hip activity, limb length, and complications were observed in the follow-up. Harris score was applied to assess limb functions. Results The mean follow-up was 4.1 years. Femoral nerve palsy occurred in 1 patient, DVT in 1 patient, infection in 1 patient, myocardial infarction and death in 1 patient 2 years after surgery. Hip functions were significantly improved compared with that before surgery, and the average difference between the lengths of the lower limbs was 0.6 cm. The average Harris hip score improved from (45.3±4.3) to(84.3±6.3) with statistical significance (t=5.836, P=0.031). Conclusions Total hip arthroplasty is a technically difficult but effective treatment for patients with hip infection combined with ankylosis, which will reduce complications and improve life quality.
作者
任姜栋
吾湖孜·吾拉木
努尔艾力江·玉山
阿斯哈尔江·买买提依明
REN Jiang-dong;Wuhuzi·Wulamu;Nuerailijiang·Yushan;Asihaerjiang·Maimaitiyiming(Department of Orthopaedics,the first affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)
出处
《中国骨与关节杂志》
CAS
2019年第12期893-899,共7页
Chinese Journal of Bone and Joint
关键词
关节成形术
置换
髋
手术后并发症
假体相关感染
关节炎
感染性
感染
髋关节
Arthroplasty,replacement,hip
Postoperative complications
Prosthesis-related infections
Arthritis,infectious
Infection
Hip joint
