目的探讨解剖型股骨假体置换治疗重度髋关节发育不良（developmental dysplasia of the hip，DDH）的疗效。 方法回顾分析2009年9月－2013年9月，48例（51髋）因重度DDH选择解剖型股骨假体行初次人工全髋关节置换术患者的临床资料。男5例（5髋），女43例（46髋）；年龄28～67岁，平均51岁。左髋25例，右髋20例；双髋3例。根据Crowe分型标准：Ⅲ型39例（44髋），Ⅳ型9例（7髋）。患者术前疼痛视觉模拟评分（VAS）为（5.72±1.84）分，Harris评分为（41.66±4.87）分。术前肢体短缩长度（4.31±0.84）cm。 结果手术时间59～110 min，平均78.6 min；住院时间6～20 d，平均12.3 d。术后切口均Ⅰ期愈合，2例并发下肢肌间静脉血栓形成。患者均获随访，随访时间10～54个月，平均29个月。9例术后早期伴跛行步态，1年内消失；其余患者步态均正常。末次随访时，VAS评分为（1.46±0.47）分，Harris评分为（88.66±3.48）分，健患侧肢体长度相差（1.15±0.33）cm，与术前比较差异均有统计学意义（P＜0.05）。X线片复查示，随访期间均无假体松动、下沉、异位骨化、骨质溶解并发症发生。 结论采用解剖型股骨假体置换治疗重度DDH，能有效缓解疼痛，改善关节功能，恢复肢体短缩，近期疗效满意
References
[1]
9. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1):45-55.
[2]
10. Hodgkinson JP, Shelly P, Wroblewski BM. The correlation between the roentgenographic apperance and operative findings at the bone-cement junction of socket in Charnley low friction arthroplasties. Clin Orthop Relat Res, 1988, (228):105-109.
[3]
11. Brooker A, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8):1629-1632.
[4]
12. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components:a radiographic analysis of loosening. Clin Orthop Relat Re, 1979, (141):17-27.
4. Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
[9]
5. Nakamura Y, Mitsui H, Kikuchi A, et al. Total hip arthroplasty using a cylindrical cementless stem in patients with a small physique. J Arthroplasty, 2011, 26(1):77-81.
[10]
8. Tamegai H, Otani T, Fujii H, et al. A modified S-ROM stem in primary total hip arthroplasty for developmental dysplasia of the hip. J Arthroplasty, 2013, 28 (10):1741-1745.
14. Flecher X, PmTatte S, Brassart N, et al. Evaluation of the hip center in total hip arthroplasty for old developmental dysplasia. J Arthroplasty, 2008, 23(8):1189-1196.
[13]
15. Stans AA, Pagnano MW, Shghnessy WJ, et al. Results of total hip arthroplasty for Crowe Type Ⅲ development hip dydplasia. Clinc Orthop Relat Res, 1998, (348):149-157.
6. Faldini C, Miscione MT, Chehrassan M, et al. Congenital hip dysplasia treated by total hip arthroplasty using cementless tapered stem in patients younger than 50 years ol:results after 12-years follow-up. J Orthop Traumatol, 2011, 12(4):213-218.
[18]
7. Biant LC, Bruce WJ, Assini JB, et al. Primary total hip arthroplasty in severe developmental dysplasia of the hip. Ten-year results using a cementless modular stem. J Arthroplasty, 2009, 24(1):27-32.
[19]
17. Saito S, Ishii T, Mori S, et al. Long-term results of bulk femoral head autograft in cementless THA for developmental hip dysplasia. Orthopedics, 2011, 34(2):88.
[20]
18. Argenson JN, Flecher X, Parratte S, et al. Anatomy of the dysplastic hip and consequences for total hip arthroplasty. Clin Orthop Relat Res, 2007, (465):40-45.
