[1]孙群周,海洋,王哲,等.髋臼结构性植骨人工全髋关节置换治疗成人发育性髋关节发育不良39例[J].中国中医骨伤科杂志,2022,30(01):70-73.
 SUN Qunzhou,HAI Yang,WANG Zhe,et al.39 Cases of Clinical Observation on Total Hip Replacement with Acetabular Structural Bone Grafting in Treating Developmental Dysplasia of the Hip with Crowe Type Ⅳ[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(01):70-73.
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髋臼结构性植骨人工全髋关节置换治疗成人发育性髋关节发育不良39例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年01期
页码:
70-73
栏目:
临床报道
出版日期:
2022-01-15

文章信息/Info

Title:
39 Cases of Clinical Observation on Total Hip Replacement with Acetabular Structural Bone Grafting in Treating Developmental Dysplasia of the Hip with Crowe Type Ⅳ
文章编号:
1005-0205(2022)01-0070-04
作者:
孙群周1海洋1王哲1阮成群1陈武林1李光明1侯洪涛1刘又文1陈柯1
1河南省洛阳正骨医院/河南省骨科医院(河南 洛阳,471000)
Author(s):
SUN Qunzhou1HAI Yang1WANG Zhe1RUAN Chengqun1CHEN Wulin1LI Guangming1HOU Hongtao1LIU Youwen1CHEN Ke1
1Luoyang Orthopedics Hospital of Henan(Henan Orthopedic Hospital),Luoyang 471000,Henan China.
关键词:
髋关节发育不良 全髋关节置换 结构植骨
Keywords:
developmental dysplasia of the hip total hip replacement acetabular structural bone grafting
分类号:
R687.4
文献标志码:
B
摘要:
目的:探讨髋臼结构性植骨人工全髋关节置换(THR)治疗成人Crowe Ⅳ型发育性髋关节发育不良的临床效果。方法:对2010年3月至2019年5月,全髋关节置换术中采用结构性植骨结合非骨水泥臼杯进行髋臼侧重建治疗的39例(44髋)成人Crowe Ⅳ型髋关节发育不良(DDH)患者的临床疗效进行回顾性分析。男6例(6髋),女33例(38髋),平均年龄52岁。术前改良Harris评分平均为(45.5±4.6)分。结果:术后平均随访42个月,末次随访改良Harris评分平均为(90.5±3.2)分。术后髋关节旋转中心平均下移3.4 cm,内移2.6 cm。所有髋臼假体无松动或感染,影像学复查显示臼杯、股骨假体嵌合良好,无松动。所有施行髋臼结构植骨均骨性愈合。结论:自体骨结构性植骨结合非骨水泥臼杯重建Crowe Ⅳ型髋关节发育不良的旋转中心,临床效果满意,是较为理想的治疗方法。
Abstract:
Objective:To investigate the clinical efficacy of total hip replacement(THR)with acetabular structural bone grafting in treating developmental dysplasia of the hip with Crowe type Ⅳ.Methods:The clinical data of 39 patients(6 males and 33 females)with Crowe type Ⅳ hip dysplasia from March 2010 to May 2019 treated with THR and acetabular structural bone grafting were retrospectively analyzed,and the average age of patients was 52 years old.The average preoperative Harris score was(45.5±4.6)points.Results:The mean follow-up time was 42 months.The average postoperative Harris score was(90.5±3.2)points.The rotation center of the hip joint moved to the lateral and medial sides,with 3.4 cm and 2.6 cm on average respectively.Imaging results showed that the acetabular cup and femoral prosthesis were well embedded without looseness.All the acetabular bone grafts were healed,and no infection was found.Conclusion:Total hip arthroplasty and acetabular structural bone grafting can be an effective method in treating the high developmental dysplasia of the hip.

参考文献/References:

[1] SHINAR A A,HARRIS W H.Bulk structural autogenous grafts and allografts for reconstruction of the acetabulum in total hip arthroplasty.Sixteen-yearaverage follow-up[J].J Bone Joint Surg Am,1997,79(2):159-168.
[2] STEPPACHER S D,TANNAST M,GANZ R,et al.Mean 20-year followup of Bernese periacetabular osteotomy[J].Clin Orthop Relat Res,2008,466(7):1633-1644.
[3] ENGH C A,MASSIN P,SUTHERS K E.Roentgenographic assessment of the biologic fixation of porous-surfaced femoral componets[J].Clin Orthop Relat Res,1990,257:107-128.
[4] DELEE J,CHARNLEY J.Radiological demarcation of cemented sockets in total hip replacement[J].Clin Orthop Relat Res,1976,121:20-32.
[5] 张先龙,蒋垚,陈云苏.人工髋关节外科学——从初次置换到翻修手术[M].北京:人民军医出版社,2009:163-164.
[6] 陈恺哲,冯建民,何川,等.自体股骨头旋转植骨重建髋臼治疗髋关节发育不良的中期疗效[J].骨科,2018,9(5):354-358.
[7] 黄兆钢.全髋关节置换术治疗先天性髋关节发育不良Ⅳ型的疗效分析[J].河北医学,2017,6(6):1017-1019.
[8] 杨述华,许伟华,叶树楠,等.髋臼重建及股骨转子下短缩截骨全髋关节置换治Crowe Ⅳ型髋关节发育不良[J].中华骨科杂志,2013,33(9):888-894.
[9] 曹力.发育性髋关节发育不良病人的全髋关节置换术:探索,挑战,求精[J].骨科,2018,9(5):337-340.
[10] LINDE F,JENSEN J.Socket loosening in arthroplasty for congenital dislocation of the hip[J].Acta Orthop Scand,1988,59(3):254-257.
[11] 程亮亮,赵德伟.成人发育性髋关节发育不良的诊治现状[J].中国骨与关节损伤,2016,7(7):516-520.
[12] 杨帆,杨磊,覃开蓉,等.成人Crowe Ⅲ~Ⅳ型发育性髋关节发育不良的全髋关节置换29例中远期随访报告[J].中国骨与关节杂志,2016,5(7):499-502.
[13] 刘诚,郭孝军.全髋关节置换术治疗成人髋关节发育不良的疗效分析[J].临床外科杂志,2018,12(12):968-970.
[14] 查国春,孙俊英,冯硕,等.髋臼外上方结构性植骨在髋关节发育不良全髋关节置换术中的应用[J].中华骨科杂志,2017,12(23):1449-1457.
[15] 刘宏鸣,朱吉桂,叶峥,等.植骨加盖行生物学固定型全髋关节置换治疗严重成人髋关节发育不良[J].中国组织工程研究,2014,6(26):4120-4124.
[16] 江源,万顺新,韩东明,等.全髋关节置换股骨头骨块重建髋臼治疗成人髋关节发育不良的临床体会[J].中国中医骨伤科杂志,2016,24(2):49-51.
[17] KIM Y L,NAM K W,YOO J J,et al.Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum [J].Clin Orthop Surg,2010,2(3):148-153.
[18] 闫飞,陈光兴,何锐,等.屈髋屈膝体位在Crowe Ⅳ型DDH非短缩截骨全髋置换避免坐骨神经损伤的应用[J].生物骨科材料与临床研究,2016,12(6):13-16.
[19] 邢赛,彭昊,陈森,等.全髋关节置换术联合转子下横行截骨治疗成人Crowe Ⅳ型发育性髋关节发育不良的疗效观察[J].广西医学,2020,2(3):245-248.
[20] 倘艳锋,李红军,朱英杰,等.Wanger cone 股骨柄联合转子下截骨治疗Crowe Ⅳ型髋关节发育不良[J].中国骨与关节杂志,2016,7(7):503-506.

更新日期/Last Update: 2022-01-18