成人发育性髋关节发育不良患者术后患髋侧膝关节病理改变及解决方法探讨
发布时间：2018-08-12 13:46
【摘要】：目的:对成人发育性髋关节发育不良(developmental dislocation of the hip DDH)病人行全髋人工关节置换术(total hip arthroplasty THA)后患髋侧膝关节残留外翻畸形问题解决方法的探讨。方法:对2015年1月至2016年12月中25名采用THA治疗成人DDH病人分成两组,一组行THA同时行髂胫束松解术,另一组暂不松解。25名全是女性。以股胫角、膝关节X线股胫角、Harris评分及KSS评分系统-又简称AKS评分为评判标准。结果:两组病人术后膝关节KSS评分均较术前降低,髋关节Harris评分均较术前增加,两组病人患髋侧膝外翻残留畸形症状较术前均有所加重,但经髂胫束松解的病人术后股胫角角度增加程度较未行髂胫束松解的病人明显减小,手术前后差异有统计学意义p0.001。随访期间未发生感染、松动及深静脉血栓形成等并发症。结论:成人DDH病人行THA后患髋关节症状好转,若不行髂胫束松解患髋侧膝关节残留外翻畸形症状没有明显改善甚至加重,膝关节评分下降。但成人DDH病人行THA同时行髂胫束松解术病人膝关节外翻情况大为缓解同时髋关节疼痛、活动障碍等症状好转,Harris评分及KSS评分明显好转。成人DDH病人行THA时行髂胫束松解术对于其术后患髋侧膝关节残留外翻畸形问题解决有着良好的效果,可以明显改善病人相关症状且可获得满意临床疗效。
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
本文编号：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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
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1 刘强;成人发育性髋关节发育不良患者术后患髋侧膝关节病理改变及解决方法探讨[D];新疆医科大学;2017年
，本文编号：2179238
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