人工全髖關節置換術治療髖臼骨折繼發創傷性關節炎近期療效觀察_《中國修復重建外科雜志》

作者：

章軍輝 , 凌晶 , 劉華 , 陶昆 , 曾志明 , 章云峰 , 何志勇 , 狄正林 , 馮建翔 , 徐榮明

寧波市第六醫院關節外科（浙江寧波，315040）;

關鍵詞：

人工全髖關節置換術髖臼骨折創傷性關節炎

DOI：

10.7507/1002-1892.20130215

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目的探討人工全髖關節置換術（total hip arthroplasty，THA）治療髖臼骨折繼發創傷性關節炎的近期療效。方法回顧分析2004年1月－2012年3月，接受THA治療的12例13髖髖臼骨折繼發創傷性關節炎患者臨床資料。其中男6例，女6例；年齡40～68歲，平均55.6歲。左髖5例，右髖6例；雙髖1例。髖臼骨折至THA時間為12～240個月，平均65.7個月。術前髖關節Harris評分為（48.8 ± 9.5）分。結果術后切口均Ⅰ期愈合，無下肢深靜脈血栓形成、感染等并發癥發生。術后10例10髖獲隨訪，隨訪時間1～7年，平均4.8年。末次隨訪時Harris評分為（86.5 ± 8.6）分，與術前比較差異有統計學意義（t=10.520，P=0.006）。 X線片復查示，髖臼假體無不穩定發生，1髖股骨柄假體下沉2 mm，2髖發生假體周圍骨溶解。2髖發生異位骨化，根據Brooker分級標準Ⅰ、Ⅱ級各1例。結論THA治療髖臼骨折繼發創傷性關節炎可獲滿意近期療效，其中術前嚴格適應證選擇、病理評估與合適的髖臼重建方法是獲得良好療效的關鍵。

引用本文： 章軍輝,凌晶,劉華,陶昆,曾志明,章云峰,何志勇,狄正林,馮建翔,徐榮明. 人工全髖關節置換術治療髖臼骨折繼發創傷性關節炎近期療效觀察. 中國修復重建外科雜志, 2013, 27(8): 990-993. doi: 10.7507/1002-1892.20130215 復制

1.	Archdeacon MT, Kazemi N, Guy P, et al. The modified Stoppa approach for acetabular fracture. J Am Acad Orthop Surg, 2011, 19(3): 170-175.
2.	Magill P, McGarry J, Queally JM, et al. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre. Injury, 2012, 43(4): 500-504.
3.	Bellabarba C, Berger RA, Bentley CD, et al. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg (Am), 2001, 83-A(6): 868-876.
4.	Weber M, Berry DJ, Harmsen WS, et al. Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg (Am), 1998, 80(9): 1295-1305.
5.	Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. J Bone Joint Surg (Am), 1964, 46: 1615-1646.
6.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An endresult study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
7.	Tompkins GS, Jacobs JJ, Kull LR, et al. Primary total hip arthroplasty with a porous-coated acetabular component. Seven-to-ten-year results. J Bone Joint Surg (Am), 1997, 79(2): 169-176.
8.	Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257): 107-128.
9.	Maloney WJ, Jasty M, Harris WH, et al. Endosteal erosion in association with stable uncemented femoral components. J Bone Joint Surg (Am), 1990, 72(7): 1025-1034.
10.	Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
11.	Nunn TR, Cheung WY, Rollinson PD. A prospective study of pyogenic sepsis of the hip in childhood. J Bone Joint Surg (Br), 2007, 89(1): 100-106.
12.	Ranawat A, Zelken J, Helfet D, et al. Total hip arthroplasty for posttraumatic arthritis after acetabular fracture. J Arthroplasty, 2009, 24(5): 759-767.
13.	Greidanus NV, Masri BA, Garbuz DS, et al. Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. J Bone Joint Surg (Am), 2007, 89(7): 1409-1416.
14.	Sermon A, Broos P, Vanderschot P. Total hip replacement for acetabular fractures result in 121 patients operated between 1983 and 2003. Injury, 2008, 39(8): 914-921.
15.	Huo MH, Solberg BD, Zatorski LE, et al. Total hip replacements done without cement after acetabular fractures in 4- to 8-year follow-up study. J Arthroplasty, 1999, 14(7): 827-831.
16.	Berry DJ, Halasy M. Uncemented acetabular components for arthritis after acetabular fractures. Clin Orthop Rel Res, 2002, (405): 164-167.
17.	Romness DW, Lewallen DG. Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg (Br), 1990, 72(5): 761-764.

1. Archdeacon MT, Kazemi N, Guy P, et al. The modified Stoppa approach for acetabular fracture. J Am Acad Orthop Surg, 2011, 19(3): 170-175.
2. Magill P, McGarry J, Queally JM, et al. Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre. Injury, 2012, 43(4): 500-504.
3. Bellabarba C, Berger RA, Bentley CD, et al. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg (Am), 2001, 83-A(6): 868-876.
4. Weber M, Berry DJ, Harmsen WS, et al. Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg (Am), 1998, 80(9): 1295-1305.
5. Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. J Bone Joint Surg (Am), 1964, 46: 1615-1646.
6. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An endresult study using a new method of result evaluation. J Bone Joint Surg (Am), 1969, 51(4): 737-755.
7. Tompkins GS, Jacobs JJ, Kull LR, et al. Primary total hip arthroplasty with a porous-coated acetabular component. Seven-to-ten-year results. J Bone Joint Surg (Am), 1997, 79(2): 169-176.
8. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257): 107-128.
9. Maloney WJ, Jasty M, Harris WH, et al. Endosteal erosion in association with stable uncemented femoral components. J Bone Joint Surg (Am), 1990, 72(7): 1025-1034.
10. Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
11. Nunn TR, Cheung WY, Rollinson PD. A prospective study of pyogenic sepsis of the hip in childhood. J Bone Joint Surg (Br), 2007, 89(1): 100-106.
12. Ranawat A, Zelken J, Helfet D, et al. Total hip arthroplasty for posttraumatic arthritis after acetabular fracture. J Arthroplasty, 2009, 24(5): 759-767.
13. Greidanus NV, Masri BA, Garbuz DS, et al. Use of erythrocyte sedimentation rate and C-reactive protein level to diagnose infection before revision total knee arthroplasty. J Bone Joint Surg (Am), 2007, 89(7): 1409-1416.
14. Sermon A, Broos P, Vanderschot P. Total hip replacement for acetabular fractures result in 121 patients operated between 1983 and 2003. Injury, 2008, 39(8): 914-921.
15. Huo MH, Solberg BD, Zatorski LE, et al. Total hip replacements done without cement after acetabular fractures in 4- to 8-year follow-up study. J Arthroplasty, 1999, 14(7): 827-831.
16. Berry DJ, Halasy M. Uncemented acetabular components for arthritis after acetabular fractures. Clin Orthop Rel Res, 2002, (405): 164-167.
17. Romness DW, Lewallen DG. Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg (Br), 1990, 72(5): 761-764.

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人工全髖關節置換術治療髖臼骨折繼發創傷性關節炎近期療效觀察

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《中國修復重建外科雜志》

人工全髖關節置換術治療髖臼骨折繼發創傷性關節炎近期療效觀察

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