Developmental hip dysplasia treated with total hip arthroplasty with threaded cup

目的 探讨使用螺旋臼假体治疗发育性髋关节发育不良 (DDH) 继发骨性关节炎患者的临床疗效.方法 自2003年5月至2007年12月,使用Zweymüller螺旋臼假体治疗40例(43髋)DDH继发骨性关节炎患者,其中男6例(6髋),女34例(37髋),平均年龄47.6岁(22～70岁);单侧37例,双侧3例;Crowe分型:Ⅰ级6例,Ⅱ级24例,Ⅲ级10例,Ⅳ级3例.平均随访24.6个月,术前Harris评分最高61分,最低22分,平均43.5分.结果 所有患者术后疼痛基本消失,双下肢长度差异平均1.2 cm,2例术后出现股神经损伤症状,术后6个月症状基本消失,Harris评分最高97分,最低62分,平均85.3分.结论 使用Zweymüller螺旋臼假体治疗DDH继发骨性关节炎的患者,可以达到良好的恢复关节功能的临床疗效,手术不需大块植骨和骨水泥,初期临床效果满意.Objective The objective of this study was to determine the outcome of total hip arthroplasty with a cementless threaded cup (Zweymuller-SL system) in patients with osteoarthritis secondary to developmental dysplasia of hip (DDH). Methods From May 2003 to December 2007, forty patients (43 hips) with developmental hip dysplasia who were treated with cementless total hip arthroplasty were followed up.The acetabular reconstruction was done with a cementless threaded cup.Among 40 patients, 6 were male, 34 were female and an average age was 47.6 years (range, 22～70 years).37 cases were unilateral DDH and 3 cases were bilateral.According to Crower′s classification, 6 were class Ⅰ, 24 caseswere class Ⅱ, 10 cases were class Ⅲ and 3 cases were class Ⅳ.The meaning following-up period was 24.6 months(range, 4～58 months).The mean preoperative Harris score was 43.5 points (range, 22～61 points).Results The pain of all patients was completely relieved.The postoperative difference of the two leg length reduced to average 1.2 cm.Sciatic palsy happened in 2 patients, but both recovered after 6 months postoperatively.Postoperative Harris score was 85.3 (range, 62～97 points).Conclusions The DDH patient treated with cementless Zewymuller threaded cup of total hip arthroplasty can get good clinical results without structural bone grafting and cementing.04393-398