BACKGROUND:Developmental dislocation of the hip is a type of adult hip dysplasia, including Crowe III and IV type; the type of dislocation of the hip is a severe prognosis. Total hip replacement is clinicaly used for the complex reconstruction of acetabulum. For injured acetabulum, autologous bone graft is effective to reconstruct acetabulum structure, provides good coverage and stability for the acetabulum. Postoperative combination with effective exercise can ensure the recovery of acetabulum function. OBJECTIVE:To analyze the correlation of prosthesis position selection during total hip replacement with clinical short- and middle-term effects of Crowel III and Crowel IV hip dislocation. METHODS:Clinical data of 28 cases of dysplasia and dislocation of the hip joint combined with severe osteoarthritis, who were treated in the Department of Joint Surgery, the Second Affiliated Hospital, Inner Mongolia Medical University from December 2011 to December 2012, were retrospectively analyzed. Al patients received total hip replacement. Implant was biological artificial total hip joint prosthesis. During 2-year folow-up, patients were rechecked by imaging regularly to analyze the imaging changes of acetabulum prosthesis position and bone graft fusion. Harris hip score was used to assess the recovery of hip function. The correlation of prosthesis position and short- and middle-term effects was analyzed. RESULTS AND CONCLUSION: The filing rate of medulary cavity of prosthesis was above 75%. The initial position was fixed and stable. The stability rate of femur-prosthesis interface reached 100%. Compared with pre-replacement, hip function was significantly improved at 6 months post surgery (t=25.55, 9.07;P < 0.05). These results indicate that total hip replacement for Crowel III and Crowel IV hip dislocation can effectively reconstruct the acetabulum, recover hip function, and stabilize prosthesis. Total hip replacement is characterized by good filing rate, high stability of femoral prosthesis interface, and stable initial fixation. The clinical repair effect is strongly associated with the position of the prosthesis.%背景：发育性髋关节脱位是成人髋关节发育不良的一种类型，其中 CroweⅢ和Ⅳ型髋关节脱位是病情较严重的类型。临床采用全髋关节置换治疗需要对髋臼进行复杂的重建处理。对受损髋臼采用自体骨植骨可有效重建髋臼的结构，为髋臼提供良好的覆盖率和稳定性，置换后结合有效的功能锻炼可保证髋臼功能的恢复。目的：分析全髋关节置换过程中假体位置选择与CroweⅢ、CroweⅣ型髋关节脱位临床短中期疗效的相关性。方法：回顾性分析2011年12月至2012年12月内蒙古医科大学第二附属医院关节外科收治的28例髋关节发育不良关节脱位并严重骨关节炎患者的临床资料，所有患者均行全髋关节置换治疗，置入材料为生物型人工全髋关节假体。随访2年，置换后定期影像学复查以分析髋臼假体位置的影像学变化及植骨融合情况，采用Harris髋关节评分对髋关节功能的恢复情况进行评价。分析患者假体位置与短中期疗效的相关性。结果与结论：置换后患者假体髓腔填充率在75%以上，初始位置固定稳定，股骨-假体界面稳定率高达100%。与置换前相比，置换后6个月患者的髋关节功能明显改善，差异有显著性意义(t=25.55，9.07；P <0.05)。提示全髋关节置换修复CroweⅢ和CroweⅣ型髋关节脱位可有效重建髋臼，恢复髋关节功能，稳定假体，具有假体填充率良好、股骨-假体界面稳定率高、初始内固定稳定等优点，其临床修复效果与假体安放的位置密切相关。
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