OBJECTIVE: To evaluate early to medium-term effectiveness of total hip arthroplasty (THA) in patients with a history of hip preservation surgery with secondary severe osteoarthritis for developmental dysplasia of the hip (DDH).
METHODS: The clinical data of 25 DDH patients (31 hips) who had severe osteoarthritis after hip preservation surgery and received THA between September 2009 and March 2021 were retrospectively analyzed. There were 1 male and 24 females; the age ranged from 18 to 65 years, with an average age of 43 years; 8 hips were classified into Crowe type Ⅰ, 9 hips were type Ⅱ, 3 hips were type Ⅲ, and 11 hips were type Ⅳ. The time between osteotomy and THA ranged from 31 to 51 years, with an average of 31.96 years. Preoperative hip flexion range of motion was (69.31±29.72)°, abduction range of motion was (24.00±14.79)°; and Harris hip score was 45.3±15.5. Postoperative Harris hip score, hip range of motion, complications, radiographic findings, and implant survival rate were analyzed.
RESULTS: Patients in both groups were followed up 2-132 months, with an average of 51 months. During the follow-up, periprosthetic fracture occurred in 1 case; there was no complication such as dislocation, periprosthetic infection, nerve palsy, or deep vein thrombosis. At last follow-up, the hip flexion range of motion was (109.52±11.17)°, abduction range of motion was (41.25±5.59)°, showing significant differences when compared with preoperative values ( t=8.260, P=0.000; t=6.524, P=0.000). The Harris hip score was 91.5±4.1, and the difference was significant when compared with preoperative score ( t=11.696, P=0.000); among them, 13 cases were excellent and 12 cases were good. Radiographic evaluation showed that the center of acetabular rotation moved up 0-18 mm (mean, 6.35 mm). The cup abductor angle was 28°-49° (mean, 37.74°) and the coverage rate was 69.44%-98.33% (mean, 81.04%). All femoral stems were fixed in neutral position without varus or valgus. No osteolysis, radiolucent line, or implant migration was observed. By the end of follow-up, none of the patients underwent revision and the survival rate of prothesis was 100%.
CONCLUSIONS: THA is still the gold standard for the treatment of DDH patients with secondary osteoarthritis after hip preservation surgery. The postoperative joint function can be rapidly restored, the patients\' quality of life can significantly improve, and the early to medium-term survival rate of the prosthesis is satisfactory.
UNASSIGNED: 评价保髋手术后继发重度骨关节炎的发育性髋关节发育不良(developmental dysplasia of the hip,DDH)患者行人工全髋关节置换术(total hip arthroplasty,THA)术后的早中期临床疗效。.
UNASSIGNED: 回顾分析2009年9月—2021年3月收治的保髋术后继发重度骨关节炎并接受THA的25例(31髋)DDH患者临床资料。男1例,女24例;年龄18~65岁,平均43岁。Crowe分型为Ⅰ型8髋,Ⅱ型9髋,Ⅲ型3髋,Ⅳ型11髋。截骨手术距此次THA时间为13~51年,平均31.96年。术前髋关节屈曲活动度(69.31±29.72)°,外展活动度(24.00±14.79)°;Harris评分(45.3±15.5)分。分析患者术后Harris评分、髋关节活动度、并发症、影像学结果和假体生存率。.
UNASSIGNED: 两组患者均获随访,随访时间2~132个月,平均51个月。1例股骨柄远端出现假体周围骨折;无髋关节脱位、假体周围感染、神经麻痹或下肢深静脉血栓形成等并发症发生。末次随访时髋关节屈曲活动度为(109.52±11.17)°,外展活动度为(41.25±5.59)°,与术前比较差异有统计学意义( t=8.260, P=0.000; t=6.524, P=0.000)。Harris评分为(91.5±4.1)分,与术前比较差异亦有统计学意义( t=11.696, P=0.000);其中优13例,良12例。影像学评估显示,髋臼旋转中心上移0~18 mm,平均6.35 mm;髋臼外展角28°~49°,平均37.74°;臼杯覆盖率为69.44%~98.33%,平均81.04%。所有股骨柄均中立位固定,未见内翻或外翻;未见假体周围骨溶解、透亮线发生;所有假体固定在位,未见松动及移位。截止随访终点,所有患者均未接受翻修手术,假体生存率为100%。.
UNASSIGNED: 对于保髋术后继发重度骨关节炎的DDH患者,THA仍是治疗该类患者的金标准,术后患者可迅速恢复关节功能,生活质量明显改善,假体的早中期生存率令人满意。.