强直性脊柱炎行非骨水泥型全髋关节置换术16例短期随访研究

发布时间：2018-04-26 13:45

  本文选题：脊柱炎 + 强直性　； 参考：《吉林大学》2015年硕士论文

【摘要】：目的： 对吉林大学第二医院骨科医院在2013年6月至2014年6月期间对强直性脊柱炎患者行非骨水泥型人工全髋关节置换术16例27髋的资料进行短期临床随访及分析，评价强直性脊柱炎行非骨水泥型人工全髋关节置换术后的短期疗效。 资料与方法： 资料：本组病例收集吉林大学第二医院骨科医院在2013年6月至2014年6月期间对强直性脊柱炎患者行非骨水泥型人工全髋关节置换术16例27髋。其中男14例24髋，女2例3髋，年龄22-62岁，平均38.4岁，右髋3例，左髋2例，双髋11例。强直性脊柱炎病史6-46年，平均17.5年。髋关节受累病史3-46年，平均14.8年。所有手术均为全髋关节置换术，其中行双侧同期置换8例16髋，一侧翻修、另一侧置换2例4髋，，右髋置换3例，左髋置换2例，两侧非同期置换1例2髋。采用假体类型：所有患者均采用非骨水泥髋和假体功能位设置。 方法：分别于术前及术后3个月、半年和1年随访过程中使用Harris评分、VAS疼痛评分、髋关节屈伸活动度对患者髋关节功能评分，并通过术后髋关节正位片测量假体外展角和前倾角来确定假体安装位置，通过SPSS系统对比术前及术后随访时的髋关节屈伸活动度、VAS疼痛评分、Harris评分，评价强直性脊柱炎行非骨水泥型人工全髋关节置换的短期疗效。 结果： 本组患者随访时间最短为12个月，最长为24个月，平均15.5个月。术前髋关节屈曲平均47.22±40.26，术后3个月平均86.74±22.19，术后半年平均92.59±19.05，术后1年随访平均103.07±19.35。术前VAS疼痛评分平均3.70±3.09，术后3个月平均0.74±0.89，术后半年平均0.37±0.67，术后1年随访平均0.33±0.54。术前Harris评分平均42.51±15.47，术后3个月平均82.59±9.84，术后半年平均88.11±9.84，术后1年随访平均91.37±9.19。均较术前有所提高。假体外展角平均40.06±10.1，前倾角平均17.0±6.2。根据术前及术后3个月、半年、1年随访评分结果分析具有统计学意义（具体见柱状图表1-3）。根据Harris评分表，评分结果为优（90-100）14髋，良（89-80）11髋，可（79-70）1髋，差（＜70）1髋。优良率92.6%。 结论： 非骨水泥型THA是治疗AS髋关节疾病一种非常有效地方法。它能够缓解患者髋关节疼痛，改善髋关节功能，提高患者的生活质量。 对于AS伴有髋关节骨性强直或纤维性强直患者，股骨颈两阶段截骨法及假体的功能位设置对于提高手术的安全性和防止关节脱位十分重要。
[Abstract]:Objective:
The short-term clinical follow-up and analysis of 16 cases of 27 hip arthroplasty with non bone cement artificial total hip replacement for patients with ankylosing spondylitis in the Department of orthopedics, Second Hospital of Jilin University from June 2013 to June 2014, were followed up and analyzed to evaluate the short-term effect of ankylosing spondylitis after non cement-based total hip replacement.
Information and methods:
Data: this group of cases collected 16 cases of 27 hip arthroplasty for ankylosing spondylitis in the Department of orthopedics, Second Hospital of Jilin University from June 2013 to June 2014. There were 14 cases of male 14 cases, 2 cases 3 hips, 22-62 years old, 38.4 years old, 3 cases of right hip, 2 cases of left hip, double hip 11, history of ankylosing spondylitis. 6-46 years, an average of 17.5 years. The history of hip joint involvement was 3-46 years, averaging 14.8 years. All the operations were total hip arthroplasty, including 8 cases of bilateral replacement, 16 hip replacement, unilateral replacement, replacement of 2 and 4 hips on the other side, 3 with right hip replacement, 2 left hip replacement, and 1 2 hips on bilateral non synchronous replacement. All patients adopted non bone cement. Functional position of hip and prosthesis.
Methods: Harris score, VAS pain score, hip flexion and extension activity were used to score the hip joint function in 3 months, six months and 1 years, respectively, and the prosthesis installation position was determined by measuring the prosthesis abduction angle and pretilt angle after the operation of hip joint, and the SPSS system was used to compare the preoperative and postoperative follow-up. The hip flexion extension activity, VAS pain score and Harris score were used to evaluate the short-term efficacy of cementless total hip arthroplasty for ankylosing spondylitis.
Result锛

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