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-  2018 

关节镜联合直接前方入路在髋关节疾病中的应用研究

DOI: doi:10.7507/1002-1892.201803115

Keywords: 髋关节镜, 直接前方入路, 股骨头骨折, 股骨颈骨折, 股骨头缺血性坏死

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Abstract:

目的探讨应用关节镜联合直接前方入路治疗髋关节疾病的近期疗效。方法2015 年 1 月—2016 年 12 月,采用关节镜下清理联合直接前方入路治疗 23 例(23 髋)髋关节疾病患者。男 9 例,女 14 例;年龄 27~49 岁,平均 38.6 岁。髋关节后脱位并股骨头骨折(Pipkin Ⅰ型)11 例、股骨颈骨折(Garden Ⅳ型)7 例,受伤至手术时间 2~8 d,平均 4.3 d;塌陷前期股骨头缺血性坏死 5 例,国际骨循环协会(ARCO)分期为ⅡA 期,病程 3~8 个月,平均 5.9 个月。术前 Harris 髋关节评分为(57.3±8.2)分,牛津大学髋关节评分(OHS)为(11.2±3.6)分,Postel 系统评分为(3.2±1.5)分,疼痛视觉模拟评分(VAS)为(7.2±1.3)分。手术联合骨折内固定或清理坏死股骨头并植骨治疗。结果术后切口均Ⅰ期愈合。3 例出现股外侧皮神经损伤。患者均获随访,随访时间 8~19 个月,平均 15.6 个月。术后骨折均愈合,愈合时间为 14~19 周,平均 15.8 周;未出现继发性骨关节炎及异位骨化等。末次随访时,Harris 髋关节评分为(92.5±5.3)分,OHS 评分为(36.5±5.9)分,Postel 系统评分为(14.2±2.6)分,均较术前显著提高(t=45.274,P=0.000;t=36.586,P=0.000;t=32.486,P=0.000);VAS 评分为(1.8±0.9)分,较术前显著降低(t=21.314,P=0.000)。结论应用关节镜联合直接前方入路治疗髋关节疾病,可有效缓解关节疼痛、改善关节功能,近期疗效满意

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