目的 探讨迟发性脊椎骨骼发育不良并渐进性关节病累及髋关节,行全髋关节置换,手术方案选择、临床疗效及术后并发症. 方法 回顾性分析自2009-2012年南京大学医学院附属鼓楼医院收治的3例迟发性脊椎骨骼发育不良并渐进性关节病者,均为女性,3例(5髋)均行全髋关节置换.术前评估全身骨骼系统,了解骨骼畸形情况.术中选择合适假体,调整双下肢长度,重建髋臼,假体均置于真臼位置.术后进行随访,了解假体情况,评估髋关节功能及疼痛缓解程度.结果 3例均获随访,最长随访时间7年,末次随访时,髋关节Harris评分平均94.6分,较术前平均33.4分明显提高,能正常行进并上下楼梯,步态良好.VAS评分均为0分,较术前(平均5.4分)疼痛明显缓解.术后无下肢深静脉血栓形成及血管、神经损伤,随访期间未发生假体松动、脱位及下沉等并发症. 结论 迟发性脊椎骨骼发育不良并渐进性关节病累及髋关节者可行全髋置换,能有效缓解关节疼痛,改善功能,提高生活质量.%Objective This paper is to explore the surgical treatment, clinical efficacy and post-operative complications of patients who have had total hip replacements caused by progressive pseudorheumatoid dysplasia. Methods We performed a retro-spective analysis on three female patients diagnosed with the progressive pseudorheumatoid dysplasia. They all received total hip arthro-plasty(five hips). We evaluated all the changes of bone system and the deformity thoroughly before the operation. We chose appropri-ate prostheses,adjusted the length of the lower limbs and made sure that all the acetabular components were placed accurately during the operation.The evaluation of the prosthesis,assessment of joint function and the extent of pain relief were conducted after the surger-ies. Results All the three patients were followed-up with the longest follow-up visit lasting for 7 years. The average Post-operative Harris score(mean was 94.6)was higher than that of preoperative(mean was 33.4).They were capable of walking up and down stairs, pacing well and taking good care of themselves.The pain in hips was relived obviously(VAS scores were 0),while the average preopera-tive VAS scores were 5.4 points.There were no post-operative complications such as deep vein thrombosis in lower limbs,vascular,nerve damage or infection. During the follow-up period, there were not any complications of loosening or dislocation or sinking of the prosthesis as well. Conclusion THA could provide good out-comes in patients with progressive pseudorheumatoid dysplasia in-volving the hip.
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