[1]谭英铨,高大伟△,陈亮.高髋中心技术在髋关节发育不良患者全髋关节置换术中的应用[J].中国中医骨伤科杂志,2023,31(05):35-39+44.[doi:10.20085/j.cnki.issn1005-0205.230507]
　TAN Yingquan,GAO Dawei,CHEN Liang.High Hip Center Technique in Total Hip Replacement for Developmental Dysplasia of the Hip[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(05):35-39+44.[doi:10.20085/j.cnki.issn1005-0205.230507]
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高髋中心技术在髋关节发育不良患者全髋关节置换术中的应用()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年05期
页码:
35-39+44
栏目:
临床研究
出版日期:
2023-05-15

文章信息/Info

Title:
High Hip Center Technique in Total Hip Replacement for Developmental Dysplasia of the Hip
文章编号:
1005-0205(2023)05-0035-05
作者:
谭英铨1; 高大伟1△; 陈亮1
1广州中医药大学附属中山中医院(广东 中山,528401)
Author(s):
TAN Yingquan1; GAO Dawei1△; CHEN Liang1
1Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan 528401,Guangdong China.
关键词:
髋臼高位放置;  髋关节发育不良;  全髋关节置换术;  髋臼重建;  高髋中心
Keywords:
high acetabular placement;  developmental dysplasia of the hip;  total hip replacement;  acetabular reconstruction;  high hip center
分类号:
R687.4
DOI:
10.20085/j.cnki.issn1005-0205.230507
文献标志码:
A
摘要:
目的:探究人工全髋关节置换术(THR)中应用高髋中心技术治疗Crowel Ⅱ、Ⅲ 型髋关节发育不良(DDH)患者的临床疗效。方法:选取2017年1月至2021年6月行人工全髋关节置换术治疗的64例(78髋)Crowe Ⅱ、Ⅲ型发育性髋关节发育不良患者进行随访,按照髋臼杯位置及Crowe分型分为3组,H2组(高位Ⅱ型)、H3组(高位Ⅲ型)、A组(解剖Ⅱ型)。比较3组Trendelenburg征、Harris评分、步态情况、术后双下肢长度差。结果:所有患者术后步态良好,无跛行,高位组术中出血量与手术时间均优于解剖组,差异有统计学意义(P<0.05)。3组术后1年Harris评分、术后引流量、下地时间、双下肢长度差的差异均无统计学意义(P>0.05)。结论:高髋中心技术是全髋关节置换术治疗CroweⅡ、Ⅲ型发育性髋关节发育不良髋臼重建的一种有效的选择,能获得良好的临床疗效,可缩短手术时间,简化手术过程,减少术中出血量。
Abstract:
Objective:To explore the efficacy of high hip center technique in toal hip replacement(THR)for Crowe type Ⅱ and Ⅲ developmental dysplasia of the hip(DDH).Methods:64 patients(78 hips)with Crowe Ⅱ to Ⅲ DDH who received total hip replacement from January 2017 to June 2021 were followed up and divided into three groups according to the location of acetabular cups and the type of Crowe.Group H2(high hip center Ⅱ),Group H3(high hip center Ⅲ)and group A(anatomical position Ⅱ).Trendelenburg sign,Harris score,operation time,intraoperative blood loss,leg length discrepancy were compared among the three groups.Results:All patients had good postoperative gait.The operative time and intraoperative bleeding in the high group were not more than the anatomic group(P<0.05).However,there was no significant statistical difference in Harris score,postoperative drainage,lower limb length difference,and time spent on the ground between the two groups at 1 years after surgery(P>0.05).Conclusion:High hip center technique in THR for Crowe Ⅱ and Ⅲ developmental dysplasia of the hip is a valuable alternative to achieve excellent clinical efficacy,which can reduce intraoperative bleeding,simplify the opertation process and shorten the operation time.

参考文献/References:

[1] GOLAFSHAN N,WILLEMSEN K,KADUMUDI F B,et al.3D-printed regenerative magnesium phosphate implant ensures stability and restoration of hip dysplasia[J].Adv Healthc Mater,2021,10(21):e2101051.
[2] 戈超,李宏宇,韦庆,等.THA治疗CroweⅡ和Ⅲ型发育性髋关节发育不良中臼杯高位和解剖位放置的临床疗效对比分析[J].广西医科大学学报,2021,38(2):338-342.
[3] MEGERIAN M F,STRONY J T,MENGERS S R,et al.Use of anatomic radiographic horizons for the lateral center-edge angle in the classification of hip dysplasia[J].Am J Sports Med,2022,50(13):3610-3616.
[4] SHIN C H,YANG E,LIM C,et al.Which acetabular landmarks are the most useful for measuring the acetabular index and center-edge angle in developmental dysplasia of the hip? A comparison of two methods[J].Clin Orthop Relat Res,2020,478(9):2120-2131.
[5] CROWE J F,MANI V J,RANAWAT C S.Total hip replacement in congenital dislocation and dysplasia of the hip[J].J Bone Joint Surg Am,1979,61(1):15-23.
[6] NAWABI D H,MEFTAH M,NAM D,et al.Durable fixation achieved with medialized,high hip center cementless THAs for Crowe Ⅱ and Ⅲ dysplasia[J].Clin Orthop Relat Res,2014,472(2):630-636.
[7] 万安营,唐淼,刘忠堂,等.高位全髋关节置换治疗CroweⅡ和Ⅲ型成人髋臼发育不良[J].中国矫形外科杂志,2020,28(1):36-40.
[8] 任鹏,柴伟,周勇刚,等.人工全髋关节置换治疗CroweⅡ、Ⅲ型发育性髋关节发育不良——非骨水泥臼杯高旋转中心安放的短期随访结果[J].中华骨与关节外科杂志,2015,8(2):145-150.
[9] 朴尚,杜银桥,周勇刚.髋臼高位放置技术在人工髋关节置换中的应用研究与进展[J].中国组织工程研究,2017,21(11):1776-1782.
[10] SAITO S,ISHII T,MORI S,et al.Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia[J].Orthopedics,2011,34(2):88.
[11] 尹诗九,钟航,李锐博,等.Crowe Ⅲ型髋关节发育不良人工全髋关节置换术中自体股骨头结构植骨重建髋臼疗效分析[J].中国修复重建外科杂志,2018,32(1):20-24.
[12] 王琦,张先龙,蒋垚,等.髋关节表面置换术治疗Crowe Ⅰ、Ⅱ型髋关节发育不良[J].中华解剖与临床杂志,2014,19(1):19-23.
[13] MONTALTI M,CASTAGNINI F,GIARDINA F,et al.Cementless total hip arthroplasty in crowe Ⅲ and Ⅳ dysplasia:high hip center and modular necks[J].J Arthroplasty,2018,33(6):1813-1819.
[14] DELIMAR D,ALJINOVIC A,BICANIC G.Failure of bulk bone grafts after total hip arthroplasty for hip dysplasia[J].Arch Orthop Trauma Surg,2014,134(8):1167-1173.
[15] 文兴贵,窦一鸣,沈先月,等.Crowe Ⅱ和Ⅲ型发育性髋关节发育不良髋臼重建的研究现状[J].中国骨伤,2022,35(1):75-79.
[16] NAWABI D H,MEFTAH M,NAM D,et al.Durable fixation achieved with medialized,high hip center cementless THAs for Crowe Ⅱ and Ⅲ dysplasia[J].Clin Orthop Relat Res,2014,472(2):630-636.
[17] KOMIYAMA K,NAKASHIMA Y,HIRATA M,et al.Does high hip center decrease range of motion in total hip arthroplasty? A computer simulation study[J].J Arthroplasty,2016,31(10):2342-2347.
[18] TAKASAGO T,GOTO T,WADA K,et al.Postoperative radiographic evaluation and simulation study for optimal cup placement in high-hip centre total hip arthroplasty[J].HIP International,2021,31(3):335-341.
[19] 郝跃峰,孙俊英,杨佩彦,等.有限高位髋关节旋转中心数学模型的推导[J].中华关节外科杂志(电子版),2007(3):172-181.
[20] STIRLING P,VIAMONT-GUERRA M R,STROM L,et al.Does cup position at the high hip center or anatomic hip center in tha for developmental dysplasia of the hip result in better harris hip scores and revision incidence? A systematic review[J].Clin Orthop Relat Res,2021,479(5):1119-1130.
[21] 黄志宇,张志奇,傅明,等.髋臼假体上移放置对髋关节发育不良全髋关节置换术后下肢长度及功能的影响[J].中华骨科杂志,2014,34(12):1225-1230.
[22] CHRISTODOULOU N A,DIALETIS K P,CHRISTO- DOULOU A N.High hip center technique using a biconical threaded zweymüller cup in osteoarthritis secondary to congenital hip disease[J].Clinical Orthopaedics & Related Research,2010,468(7):1912-1919.
[23] WEN X,ZUO J,LIU T,et al.Bone defect map of the true acetabulum in hip dysplasia(Crowe type Ⅱ and Ⅲ)based on three-dimensional image reconstruction analysis[J].Sci Rep,2021,11(1):22955.
[24] 周建伟,魏锦强,周俊德,等.3D打印模型辅助全髋关节置换术治疗成人先天性髋关节发育不良的Meta分析[J].生物骨科材料与临床研究,2022,19(1):58-66.

备注/Memo

备注/Memo:
基金项目:中山市社会公益与基础研究项目(2020SYF03)
中山市科技局项目(2022B1124)
△通信作者 E-mail:335358491@qq.com
更新日期/Last Update: 2023-05-10