全髋关节置换术治疗成人先天性髋关节脱位伴骨性关节炎

目的 探讨全髋关节置换术治疗成人先天性髋关节脱位伴骨性关节炎的疗效。方法 2000年6月～2006年3月，对24例（30髋）成人先天性髋关节脱位伴骨性关节炎患者进行了全髋关节置换。其中双侧6例，单侧18例。年龄45～67岁。并对其疗效进行分析，疗效评价根据Harris评分而分为优、良、可、差四级。结果 所有患者手术顺利进行，术后伤口均一期愈合。术后5月，患者均能下地行走，生活自理且恢复日常工作。平均Harris评分由术前的（46．2±8．7）分恢复到术后1年的（90．5±7．4）分，术后与术前Harris评分比较t=17．6714（P〈0．05），其中评定为优13髋、良14髋、可2髋、差1髋，术后优良率达90．00％。术后髋关节脱位1例。本组病例无肺栓塞、深静脉血栓形成、感染等并发症发生。随访6～49月，X线检查示假体位置良好。结论 全髋关节置换术是治疗成人先天性髋关节脱位伴骨性关节炎的一种有效方法。

Clinical Effect of Treatment of Osteoarthritis Resulted from Congenital Dislocation of the Hip with Total Hip Replacement

Objective To explore retrospectively clinical effect of treatment of osteoarthritis resulted from congenital dislocation of the hip with total hip replacement. Methods Twenty six cases with osteoarthritis resulted from congenital dislocation of the hip had been treated with total hip replacement（THR） between Aug. 2000 and Nov. 2006. Thirty hips in twenty six patients with osteoaahritis resulted from congenital dislocation of the hip had been treated with total hip replacement. There were 6 out of the 24 patients in bilateral hip and 18 out of the 24 patients in unilateral hip. The age of the patients at surgery ranged from 45 - 67 years. The effect of the treatment had been evaluated. The clinical outcomes were graded into excellent, good, fair and poor basing on the Harris score system. Results The operations had been performed successfully, and the incision had healed well in I stage. All patients had walked independently without aiding, taken care of themselves and returned to the job, which they had engaged in pre-operative, in 5 months post-operation. The pre-operation functional scores of hips averaged 46.2 _＋ 8.7, and post-operation functional scores 90.5 _＋ 7.4. The difference had statistical significance between post-operation functional scores and pre-opemtion functional scores of hips （t = 17.6714, P 〈 0.05）. The hip function were excellent in 13 hip,good in 14 hip,fair in 2 hip and poor in 1 hip out of the 24 cases, and the rate of both excellent and good of the hips were 90.00% according to the Harris score system. The dislocation of hip had happened in 1 cases post-operatively, and no others complications in the series. The mean followed up period was 22.9 months, ranging from 6 to 49 months, and the position of the components were radiographic sati-sfactory. Conclusions THR is an effective way in treating osteoarthritis resulted from congenital dislocation of the hip.