上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (12): 1544-.doi: 10.3969/j.issn.1674-8115.2012.12.005

• 专题报道（骨关节疾病） • 上一篇    下一篇

髋臼内移技术在全髋关节置换术治疗髋关节发育不良中的应用

易诚青, 马春辉, 李 夏, 周晓凯, 曹 云   

  1. 上海交通大学附属第一人民医院骨科, 上海 200080
  • 出版日期:2012-12-28 发布日期:2012-12-31
  • 通讯作者: 曹 云, 电子信箱: caoyun3000@126.com。
  • 作者简介:易诚青（1974—）, 男, 副主任医师, 博士, 硕士生导师；电子信箱: ycq3000@126.com。

Application of medial protrusion technique in total hip arthroplasty for developmental dysplasia hips

YI Cheng-qing, MA Chun-hui, LI Xia, ZHOU Xiao-kai, CAO Yun   

  1. Department of Orthopaedics, the First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China
  • Online:2012-12-28 Published:2012-12-31

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摘要：

目的 探讨髋臼内移技术在全髋关节置换术（THA）治疗髋关节发育不良（DDH）中的应用效果。方法 分析31例（38髋）接受THA的CroweⅡ～Ⅳ型DDH患者（术中均应用髋臼内移技术）的临床资料。观察术后早期并发症；通过影像学检查和Harris评分评价术后功能。结果 术中发现髋臼骨折3例；术后发生早期脱位1例（术后3个月）、臼缘－股骨颈撞击综合征3例、臼杯移位1例。术中获得平均髋臼内移距离为12 mm (5～20 mm),平均臼杯覆盖率为85%(70%～100%)。平均髋臼外展角为47.5°(42°～65°)，其中4例臼杯外翻位置入（外展角>60°)。术前平均Harris评分为46.6 (38～77)，术后为83.0 (65～92)，差异有统计学意义（P<0.05）。结论 髋臼内移技术是一种有效的DDH髋臼重建技术，但需要准确的术前计划及良好的术中操作，以避免早期并发症的发生。

关键词: 髋臼内移技术, 髋关节发育不良, 髋关节置换术, 并发症

Abstract:

Objective To investigate the application of medial protrusion technique in total hip arthroplasty (THA) for developmental dysplasia hips (DDH). Methods The clinical data of 31 patients (38 hips) with DDH of Crowe typeⅡ-Ⅳundergoing THA were retrospectively analysed, and all patients were treated with medial protrusion technique in THA. The incidence of complications early after operation was observed, and Harris scores and radiological measurements were used for function evaluation after operation. Results Three cases of acetabular fractures were identified during operation. One case of posterior dislocation (3 months after operation), three cases of impingement syndrome and one case of cup displacement were found after operation. The mean distance of medial placement was 12 mm (5 to 20 mm), with a mean acetabular coverage of 85% (70% to 100%). The average inclination angle was 47.5°(42°to 65°), and valgus placement of acetabular components was found in 4 cases with inclination angle over 60°. The mean Harris score was 46.6 (38-77) before operation and 83.0 (65-92) after operation, and there were significant differences between them （P<0.05）. Conclusion The medial protrusion technique is effective in reconstruction of the hip rotator center in THA for DDH. However, precise preoperative planning and controllable operative techniques are required to decrease the incidence of complications early after operation.

Key words: medial protrusion technique, developmental dysplasia hip, total hip arthroplasty, complication