摘要
目的 观察无股骨截骨全髋关节置换术治疗Crowe Ⅳ型成人发育性髋关节发育不良的临床疗效。方法 回顾性分析自2017-02—2021-05采用全髋关节置换术治疗的90例Crowe Ⅳ型成人发育性髋关节发育不良,44例术中靠近股骨小粗隆进行股骨颈截骨(无股骨截骨组),46例术中需要进行股骨粗隆下截骨(股骨截骨组)。比较两组术后并发症发生率、末次随访时髋关节功能Harris评分。结果 90例均获得随访,随访时间平均27(12~42)个月。无股骨截骨组术后出现7例(15.9%)并发症,其中3例(6.8%)双下肢不等长,2例膝关节疼痛,1例感染,1例髋关节脱位。股骨截骨组术后出现11例(23.9%)并发症,其中6例(13.0%)双下肢不等长,2例髋关节脱位,1例感染,1例假体松动,1例膝关节疼痛。无股骨截骨组与股骨截骨组术后总并发症发生率差异无统计学意义(χ~2=0.900,P=0.343),两组术后双下肢不等长发生率比较差异无统计学意义(P=0.325)。无股骨截骨组末次随访时髋关节功能Harris评分为(84.24±5.03)分,股骨截骨组为(85.35±4.35)分,组间差异无统计学意义(t=1.121,P=0.265)。结论 无股骨截骨全髋关节置换术治疗Crowe Ⅳ型成人发育性髋关节发育不良疗效满意,假体放置准确且固定可靠,明显改善了患者髋关节功能与生活质量,但是术前需充分评估患者股骨头脱位高度、髋臼形态、股骨颈前倾角。
Objective To observe the clinical effect of total hip arthroplasty without femoral osteotomy in the treatment of adult Crowe typeⅣdevelopmental hip dysplasia.Methods Ninety patients with adult Crowe typeⅣdevelopmental hip dysplasia who underwent total hip arthroplasty from February 2017 to May 2021 were retrospectively analyzed.According to the differenc⁃es in total hip arthroplasty,44 cases were divided into the without femoral osteotomy group(femoral neck osteotomy near the lesser femoral trochanter),and 46 cases into the femoral osteotomy group(femoral subtrochanteric osteotomy).The postoperative complication rate,Harris hip score were compared between two groups.Results All 90 patients were followed up for an aver⁃age of 27(12-42)months.There were 7 cases(15.9%)of postoperative complications in the group without femoral osteotomy,in⁃cluding 3 cases(6.8%)of lower limbs,2 cases of knee pain,1 case of infection,and 1 case of hip dislocation.In the femur osteot⁃omy group,complications occurred in 11 cases(23.9%),including 6 cases(13.0%)of lower limbs,2 cases of hip dislocation,1 case of infection,1 case of prosthesis loosening,and 1 case of knee pain.There were no significant difference in the incidence of postoperative complications(χ2=0.900,P=0.343)and unequal length of lower limbs(P=0.325)between the without femoral oste⁃otomy group and the femoral osteotomy group.At the last follow-up,the Harris score of hip function was(84.24±5.03)points in the without femoral osteotomy group and(85.35±4.35)points in the femoral osteotomy group,with no statistically significant dif⁃ference between 2 groups(t=1.121,P=0.265).Conclusion Total hip arthroplasty without femoral osteotomy in the treatment of adult Crowe typeⅣdevelopmental hip dysplasia is satisfactory,and the placement of prostheses is accurate and reliable,which significantly improves the hip function and quality of life of patients.However,the height of femoral head dislocation,acetabu⁃lum morphology,and femoral neck anterior tilt of patients should be fully evaluated before surgery.
作者
王旭刚
王福顺
陈军
王志奇
王煜
伏鹏
WANG Xugang;WANG Fushun;CHEN Jun;WANG Zhiqi;WANG Yu;FU Peng(Department of Orthopedics,Baoji Hospital Affiliated Xi’an Medical University,Xi’an,Shaanxi 721006,China)
出处
《中国骨与关节损伤杂志》
2023年第6期561-565,共5页
Chinese Journal of Bone and Joint Injury
