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1、中国骨伤2006年8月第19卷第8期ChinaJOrthop&Trauma,Aug.2006,Vo.l19,No.8481临床研究变异髋臼初次全髋人工关节置换术前设计及临床意义赵铁军,张洪美,陈卫衡,顾立军,孙钢,刘道兵,尹天,张淳(中国中医科学院望京医院骨关节一科,北京100102)摘要!目的:探讨变异髋臼初次全髋人工关节置换术中髋臼假体的正确放置位置及手术疗效。方法:对34例(38髋)接受全髋关节置换的髋臼变异的各类髋关节疾病进行术前设计,其中男20例,女14例,平均年龄56.1岁(29~75岁)。股
2、骨头坏死继发骨性关节炎15例(19髋),髋臼发育不良继发骨性关节炎12例,创伤性骨关节炎5例,髋关节融合术后1例,髋关节人工股骨头置换术后1例。结果:术后患者均获得随访,平均随访11个月(5~38个月)。根据Harris髋关节功能评分评定,优(>90分)12髋,良(80~90分)23髋,尚可(70~79分)3髋,失败0髋(<70分)。评定结果:术前Harris评分平均47.9分,术后平均90.3分。结论:对于髋臼解剖结构异常的髋关节疾病患者行全髋人工关节置换时,通过术前对髋臼正确位置的设计,使髋关节中心置于正确的位置上,既
3、可简化术中操作的难度,又可以使臼杯假体得到牢固固定及良好的骨覆盖,有利于人工全髋关节的长期疗效。关键词!髋臼;畸形;关节成形术,置换,髋PreoperativedesignanditsclinicalsignificanceofthefirsttimetotalhiparthroplastyforthevariantacetabularZHAOTiejun,ZHANGHongmei,CHENWeiheng,GULijun,SUNGang,LIUDaobing,YINTian,ZHANGChun.Depa
4、rtmentofthe1stOrthopaedicBoneandJoint,WangjingHospital,ChinaAcademyofChineseMedicineScience,Beijing100102,ChinaABSTRACTObjective:Tostudycorrectpositionofacetabularprothesisanditseffectsonoperativeresultsoftotalhiparthroplastyforvariantacetabular.Methods:Preoperat
5、ivedesignwasperformedin34patients(38hips)withvariantacetabularundergonetotalhiparthroplastyforthetreatmentofhipjointdiseases.Amongthem,20patientsweremaleand14patientswerefemale,ranginginagefrom29to75years(mean56.1years).Amongthepatients,15patientshadfemoralheadne
6、crosiswithsecondaryosteoarthritis,12patientshadacetabulardysplasiawithsecondaryosteoarthritis,5patientshadtraumaticosteoarthritis,1patientunderwentfusionofhipjoint,and1patientunderwentartificialfemoralheadreplacement.Reults:Thirtyfourpatients(38hips)werefollowe
7、dupfrom5to38months,withanaverageof11months.ThehipfunctionswereevaluatedbyHarrisscore:12hipsreachedexcellentresults(>90scores),23hipsgood(80to90scores),3hipsfair(70to79scores),andnopoor(<70scores).ThemeanHarrishipscorewas47.9beforeoperationand90.3afteroperation.C
8、onclusion:Preoperativedesignofacetabularcorrectposition,especiallycorrectacetabularcenterposition,cannotonlyreduceoperationdifficultyintotalhiparthropla
