成人發(fā)育性髖關(guān)節(jié)發(fā)育不良患者術(shù)后患髖側(cè)膝關(guān)節(jié)病理改變及解決方法探討
發(fā)布時(shí)間：2018-08-12 13:46
【摘要】：目的:對(duì)成人發(fā)育性髖關(guān)節(jié)發(fā)育不良(developmental dislocation of the hip DDH)病人行全髖人工關(guān)節(jié)置換術(shù)(total hip arthroplasty THA)后患髖側(cè)膝關(guān)節(jié)殘留外翻畸形問(wèn)題解決方法的探討。方法:對(duì)2015年1月至2016年12月中25名采用THA治療成人DDH病人分成兩組,一組行THA同時(shí)行髂脛束松解術(shù),另一組暫不松解。25名全是女性。以股脛角、膝關(guān)節(jié)X線(xiàn)股脛角、Harris評(píng)分及KSS評(píng)分系統(tǒng)-又簡(jiǎn)稱(chēng)AKS評(píng)分為評(píng)判標(biāo)準(zhǔn)。結(jié)果:兩組病人術(shù)后膝關(guān)節(jié)KSS評(píng)分均較術(shù)前降低,髖關(guān)節(jié)Harris評(píng)分均較術(shù)前增加,兩組病人患髖側(cè)膝外翻殘留畸形癥狀較術(shù)前均有所加重,但經(jīng)髂脛束松解的病人術(shù)后股脛角角度增加程度較未行髂脛束松解的病人明顯減小,手術(shù)前后差異有統(tǒng)計(jì)學(xué)意義p0.001。隨訪(fǎng)期間未發(fā)生感染、松動(dòng)及深靜脈血栓形成等并發(fā)癥。結(jié)論:成人DDH病人行THA后患髖關(guān)節(jié)癥狀好轉(zhuǎn),若不行髂脛束松解患髖側(cè)膝關(guān)節(jié)殘留外翻畸形癥狀沒(méi)有明顯改善甚至加重,膝關(guān)節(jié)評(píng)分下降。但成人DDH病人行THA同時(shí)行髂脛束松解術(shù)病人膝關(guān)節(jié)外翻情況大為緩解同時(shí)髖關(guān)節(jié)疼痛、活動(dòng)障礙等癥狀好轉(zhuǎn),Harris評(píng)分及KSS評(píng)分明顯好轉(zhuǎn)。成人DDH病人行THA時(shí)行髂脛束松解術(shù)對(duì)于其術(shù)后患髖側(cè)膝關(guān)節(jié)殘留外翻畸形問(wèn)題解決有著良好的效果,可以明顯改善病人相關(guān)癥狀且可獲得滿(mǎn)意臨床療效。
[Abstract]:Objective: to investigate the solution of residual valgus deformity of hip joint after total hip arthroplasty (total hip arthroplasty THA) in adult patients with developmental hip dysplasia (developmental dislocation of the hip DDH). Methods: from January 2015 to December 2016, 25 adult DDH patients treated with THA were divided into two groups. One group was treated with THA and the other group was treated with iliotibial tract release. The Harris score and KSS scoring system of femur tibial angle and knee joint X ray were taken as the criterion. Results: the KSS score of knee joint in both groups was lower than that before operation, and the Harris score of hip joint was higher than that before operation. The residual deformity symptom of hip side valgus in both groups was worse than that before operation. However, the angle of femoral tibial angle increased significantly in patients with iliotibial tract release than that in patients without iliotibial tract release, and the difference before and after operation was statistically significant (p 0.001). There were no complications such as infection, loosening and deep venous thrombosis during follow-up. Conclusion: the symptoms of hip joint in adult patients with DDH were improved after THA. If not, the symptoms of residual valgus deformity of hip joint were not obviously improved or even aggravated, and the score of knee joint was decreased. But in adult DDH patients with THA and iliotibial tract lysis, the valgus of knee joint was alleviated and the symptoms of hip joint pain were relieved, and the symptoms such as dyskinesia and KSS score were improved obviously. The treatment of iliotibial tract lysis in adult DDH patients with THA has a good effect on solving the problem of residual valgus deformity of the affected hip and knee joint after operation, and can obviously improve the symptoms of the patients and obtain satisfactory clinical results.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.4
本文編號(hào)：2179238
[Abstract]:Objective: to investigate the solution of residual valgus deformity of hip joint after total hip arthroplasty (total hip arthroplasty THA) in adult patients with developmental hip dysplasia (developmental dislocation of the hip DDH). Methods: from January 2015 to December 2016, 25 adult DDH patients treated with THA were divided into two groups. One group was treated with THA and the other group was treated with iliotibial tract release. The Harris score and KSS scoring system of femur tibial angle and knee joint X ray were taken as the criterion. Results: the KSS score of knee joint in both groups was lower than that before operation, and the Harris score of hip joint was higher than that before operation. The residual deformity symptom of hip side valgus in both groups was worse than that before operation. However, the angle of femoral tibial angle increased significantly in patients with iliotibial tract release than that in patients without iliotibial tract release, and the difference before and after operation was statistically significant (p 0.001). There were no complications such as infection, loosening and deep venous thrombosis during follow-up. Conclusion: the symptoms of hip joint in adult patients with DDH were improved after THA. If not, the symptoms of residual valgus deformity of hip joint were not obviously improved or even aggravated, and the score of knee joint was decreased. But in adult DDH patients with THA and iliotibial tract lysis, the valgus of knee joint was alleviated and the symptoms of hip joint pain were relieved, and the symptoms such as dyskinesia and KSS score were improved obviously. The treatment of iliotibial tract lysis in adult DDH patients with THA has a good effect on solving the problem of residual valgus deformity of the affected hip and knee joint after operation, and can obviously improve the symptoms of the patients and obtain satisfactory clinical results.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.4
【相似文獻(xiàn)】
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1 劉強(qiáng);成人發(fā)育性髖關(guān)節(jié)發(fā)育不良患者術(shù)后患髖側(cè)膝關(guān)節(jié)病理改變及解決方法探討[D];新疆醫(yī)科大學(xué);2017年
，本文編號(hào)：2179238
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