本文選題：人工全髖關(guān)節(jié)置換術(shù) + 發(fā)育性髖關(guān)節(jié)發(fā)育不良　； 參考：《中國人民解放軍醫(yī)學(xué)院》2015年碩士論文

【摘要】：目的：擬探討人工全髖關(guān)節(jié)置換術(shù)(Total hip arthroplasty,THA)治療CroweⅡ、Ⅲ型發(fā)育性髖關(guān)節(jié)發(fā)育不良(Developmental dysplasia of the hip,DDH),非骨水泥臼杯高位安放的短期臨床及放射學(xué)結(jié)果。方法：回顧2011年6月至2013年6月,29例(37髖)CroweⅡ、Ⅲ型髖關(guān)節(jié)發(fā)育不良患者接受人工全髖關(guān)節(jié)置換術(shù),其臼杯高于解剖旋轉(zhuǎn)中心安放(高旋轉(zhuǎn)中心組)。選擇同時期的28例(35髖)CroweⅠ型患者作為對照。比較兩組患者的髖關(guān)節(jié)Harris評分、步態(tài)、跛行、Trendelanburg征、放射學(xué)檢查旋轉(zhuǎn)中心相對于淚滴連線的垂直距離(旋轉(zhuǎn)中心高度)、相對于淚滴垂線的水平距離,雙下肢長度差異以及有無放射學(xué)透亮線。結(jié)果：平均隨訪2.2年。CroweⅡ、Ⅲ型的臼杯旋轉(zhuǎn)中心距淚滴連線的平均垂直距離分別為25.5mm、29.7mm,與CroweⅠ型(18.7mm)比較有顯著統(tǒng)計學(xué)差異(P=0.02)。CroweⅡ、Ⅲ型臼杯旋轉(zhuǎn)中心距淚滴垂線的水平距離分別為27.4 mm、28.4 mmm。、與CroweⅠ型(27.8 mm)比較無顯著統(tǒng)計學(xué)差異(P=0.23)。術(shù)后雙下肢長度差異：臼杯高位安放組CroweⅡ型患者平均為3.3 mm,CroweⅢ型為3.6 mm,解剖位安放臼杯的Ⅰ型DDH為3.2 mm。臼杯高位組與解剖位組比較無顯著統(tǒng)計學(xué)差異(P=0.17)。末次隨訪時,高旋轉(zhuǎn)中心組的平均Harris評分為92.3分(86-98分),對照組的平均Harris評分為92.8分(84-100分),兩組比較無顯著統(tǒng)計學(xué)差異(P=0.57)。所有患者步態(tài)良好,無跛行,Trendelanburg征陰性。結(jié)論：人工全髖關(guān)節(jié)置換術(shù)治療CroweⅡ、Ⅲ型DDH時,臼杯高位安放是一種可靠的方法,可以獲得良好的宿主骨覆蓋,短期臨床及放射學(xué)結(jié)果良好。但需要將旋轉(zhuǎn)中心盡量內(nèi)移,另外需要恢復(fù)偏距并保證雙下肢等長,以恢復(fù)臀中肌張力,增強臀中肌力量。
[Abstract]:Objective: To investigate the short-term clinical and radiological results of Total hip arthroplasty (THA) in the treatment of Crowe II, type III developmental dysplasia of the hip (Developmental dysplasia of the hip, DDH), and the high placement of the non cement mortar cup. Methods: retrospective June 2011 to June 2013, 29 cases (37 hips) Crowe II, type III Patients with dysplasia of the hip received total hip replacement. The cup was higher than the anatomical rotation center (high rotation center). 28 patients (35 hips) of the same period (35 hips) Crowe I patients were selected as control. The hip joint Harris score, gait, claudication, Trendelanburg sign, and radiological examination of the rotation center relative to the tear drop of the two groups were compared. The vertical distance (the height of the rotation center), the horizontal distance relative to the tear vertical line, the difference of the length of the lower limbs and the radiographic bright line. Results: the average follow-up of the average follow-up of 2.2 years.Crowe II, the average vertical distance between the center of the cup rotation of the type III cup and the tear line was 25.5mm, 29.7mm, compared with the Crowe type I (18.7mm). The horizontal distance between P=0.02.Crowe II and type III cup rotation center was 27.4 mm and 28.4 mmm., respectively, and there was no significant difference from Crowe type I (27.8 mm) (P=0.23). The difference of the length of lower extremities after operation was 3.3 mm, Crowe III was 3.6 mm, and the anatomic position was placed in the cup. There was no significant difference between the 3.2 mm. cup high position group and the anatomic group (P=0.17). At the last follow-up, the average Harris score of the high rotation center group was 92.3 (86-98), the average Harris score of the control group was 92.8 (84-100), and there was no significant statistical difference (P=0.57) in the control group (P=0.57). All patients had good gait, no limp, Tre Conclusion: ndelanburg is negative. Conclusion: when Crowe II and type III DDH are treated by total hip arthroplasty, high placement of the cup is a reliable method, which can obtain good host bone cover and good short-term clinical and radiological results. However, the rotation center should be moved as far as possible, and the offset distance should be restored and the equal length of the lower extremities should be restored to restore the buttock. The muscle tension of the middle muscle strengthens the strength of the gluteus medius.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.4

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本文編號：1811938