柯岩;张蔷;马云青;李儒军;陶可;桂先革;李克鹏;张洪;林剑浩;

• 1:北京大学人民医院骨关节科
• 2:解放军总医院第四医学中心骨一科
• 3:浙江医院骨一科
• 4:保定市第二中心医院骨科

摘要(Abstract)：

目的:脊柱骨骺发育不良(spondyloepiphyseal dysplasia,SED)患者因骨骼、关节发育异常,生物力学改变和早年手术干预等往往导致严重的髋关节骨关节炎。本研究探讨人工全髋关节置换术治疗SED患者T?nnis 3级髋关节骨关节炎的早期疗效及可能的影响。方法:2017年1月至2019年6月,将由高年资医生完成人工全髋关节置换术治疗的374例髋关节骨关节炎患者作为研究对象,其中因SED行人工全髋关节置换术的患者9例(男6例,女3例,12髋)符合纳入排除标准,观察人工全髋关节置换术对该类患者的早期疗效。结果:所有患者均选用强生陶瓷内衬-陶瓷股骨头,均获得随访,平均随访时间20个月,除1例出现肌间静脉血栓外,其余患者均未出现无菌性松动、脱位、骨折、血管神经损伤、深静脉血栓和感染等并发症。术前髋关节Harris评分平均35.55分,美国西部Ontario和McMaster大学骨关节炎指数评分(the Western Ontario and McMaster Universities osteoarthritis index,WOMAC)平均56.56分,SF-12生活质量量表评分平均41.56分,视觉模拟评分(visual analogue scale,VAS)平均7.44分;末次随访时Harris评分平均89.56分,WOMAC骨关节炎指数评分平均41.11分,SF-12评分平均56.33分,VAS评分平均2.67分。与全髋关节置换术术前相比,SED患者术后骨盆入射角、骨盆倾斜角和骶骨倾斜角等骨盆相关参数均有所增加,术前平均骨盆入射角为68.95°±4.60°、平均骨盆倾斜角为52.75°±1.06°、平均骶骨倾斜角为17.45°±1.77°,而术后则相应变为76.98°±5.12°、60.51°±4.35°和18.10°±2.02°。患者术后双下肢均基本等长。结论:人工全髋关节置换是治疗SED患者T?nnis 3级髋关节骨关节炎的一种有效手术方式,且早期疗效满意。

关键词(KeyWords)： 全髋关节置换术;T?nnis分级;脊柱骨骺发育不良;髋骨关节炎

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81672183);; 北京市自然科学基金(7182172);; 北京大学人民医院院内发展基金(RDY2018-04、RDY2016-15)~~

作者(Author): 柯岩;张蔷;马云青;李儒军;陶可;桂先革;李克鹏;张洪;林剑浩;

Email:

DOI: 10.19723/j.issn.1671-167X.2021.01.026

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