Objective:To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe Ⅳ devel-opmental dysplasia of the hip(DDH).Methods:From April 2008 to December 2015,137 hips of 111 Crowe Ⅳ DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon,which consists of 85 unilateral hips and 26 bilat-eral hips.The average age of the patients was(38.88±10.83)years old ranging from 18 to 68 years old.The mean follow-up was (41.16±21.50)months ranging from 12 to 96 months.All the patients were evaluated by Harris Hip Score.Radiographic eval-uations were made preoperatively and during follow-up.Harris scores,the incidence of complications such as ceramic fracture, squeaking,dislocation were observed. Results:The mean preoperative Harris score was 56.54±15.67,the mean postoperative Harris score was 88.30±6.86(P=0.017).Periprosthetic osteolysis was not deteced around any cup.No ceramic fracture oc-curred.There were 3 cases of revision surgery due to infection,losening of the stem and limb length discrepancy,respectively;3 cases of dislocation occurred.Seventy-seven patients were recorded the gait and the hip mobility,the hip flexion of 69 pa-tients were above 120 degrees.Conclusion:Ceramic on ceramic bearing showed an encouraging result in Crowe Ⅳ DDH total hip arthroplasty.%目的:观察陶瓷对陶瓷全髋关节置换术(THA)在CroweⅣ型髋关节发育不良(DDH)中的临床应用效果.方法:回顾性分析2008年4月至2015年12月由同一名高年资医生应用第3代或第4代陶瓷对陶瓷界面对CroweⅣ型DDH 行THA患者111例(137髋),单侧85例,双侧26例,年龄18～68(38.88±10.83)岁,随访时间12～96(41.16± 21.50)个月.术前及术后随访均拍摄X线片进行观察,并采用Harris评分对临床效果进行评价.观察术后Harris评分的改善,陶瓷碎裂、异响以及脱位等并发症的发生率.结果:Harris评分由术前56.54±15.67提高至术后88.30±6.86(P=0.017).未发现假体周围明显骨溶解,无陶瓷碎裂发生.3髋分别因感染、股骨柄松动、下肢不等长翻修;3髋脱位.77例患者记录步态及髋关节活动度,其中69例患者髋关节屈曲可达120°以上.结论:在CroweⅣ型DDH行THA中应用陶瓷对陶瓷界面可达到较好的临床效果.
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