• 南華大學(xué)第一附屬醫(yī)院骨科（湖南衡陽，421001）;

【摘 要】 目的  探討人工全髖關(guān)節(jié)置換治療髖臼內(nèi)陷癥的方法及早期療效。 方法  2006年1月－2010年2月，
收治髖臼內(nèi)陷癥16例16髖。男6例，女10例；年齡39～72歲，平均56.5歲。病程1年6個月～35年，中位病程6.4年。左髖7例，右髖9例。原發(fā)性3例，繼發(fā)性13例。髖關(guān)節(jié)Harris評分為（49.5 ± 5.5）分。髖臼內(nèi)陷按Dunlop等的診斷標(biāo)準(zhǔn)分度：輕度3例，中度9例，重度4例。患者均行人工全髖關(guān)節(jié)置換，髖臼重建時采用植骨及非骨水泥型髖臼假體恢復(fù)患髖股骨偏心距及髖臼旋轉(zhuǎn)中心。 結(jié)果  術(shù)后16例切口均Ⅰ期愈合，無感染及下肢深靜脈血栓形成等并發(fā)癥發(fā)生?；颊呔@隨訪，隨訪時間12～62個月，平均37個月。末次隨訪時，髖關(guān)節(jié)Harris評分為（90.5 ± 4.5）分，與術(shù)前比較差異有統(tǒng)計學(xué)意義（t=49.578，P=0.000）。X線片顯示假體位置良好，無松動、下沉，植骨與髖臼融合，無髖臼再次內(nèi)陷。 結(jié)論  人工全髖關(guān)節(jié)置換治療髖臼內(nèi)陷時，采用植骨及非骨水泥型髖臼假體恢復(fù)患髖股骨偏心距及髖臼旋轉(zhuǎn)中心，可獲滿意早期療效。

引用本文： 陳志偉,袁杰,曹盛俊,廖瑛. 人工全髖關(guān)節(jié)置換治療髖臼內(nèi)陷癥的早期療效. 中國修復(fù)重建外科雜志, 2012, 26(3): 292-295. doi: 復(fù)制

1. Van De Velde S, Fillman R, Yandow S. The aetiology of protrusio acetabuli. Literature review from 1824 to 2006. Acta Orthop Belq, 2006, 72(5): 524-529.
2. Lundby R, Kirkhus E, Hald J, et al. CT of the hips in the investigation of protrusio acetabuli in Marfan syndrome. A case control study. Eur Radiol, 2011, 21(7): 1485-1491.
3. Dunlop CC, Jones CW, Maffulli N. Protrusio Acetabuli. Bull Hosp Jt Dis, 2005, 62(3-4): 105-114.
4. Ries MD. Total hip arthroplasty in acetabular protrusio. Orthopedics, 2009, 32(9): 666-668.
5. Vann MA, Onyike A, Gentry SW, et al. Atraumatic acetabular fracture in secondary protrusio acetabuli: a case report. J Surq Orthop Adv, 2007, 16(2): 93-97.
6. Sathappan SS, Strauss EJ, Ginat D, et al. Surgical challenges in complex primary total hip arthroplasty. Am J Orthop (Belle Mead NJ), 2007, 36(10): 534-541.
7. 童培健, 王興中, 肖魯偉. 人工全髖關(guān)節(jié)置換術(shù)中偏心距重建對髖關(guān)節(jié)功能的影響. 中華骨科雜志, 2007, 27 (11): 820-822.
8. 毛遠(yuǎn)青, 孫月華, 王友, 等. 髖臼內(nèi)陷癥的全髖關(guān)節(jié)置換術(shù). 中華骨科雜志, 2011, 31(2): 143-148.
9. Canale ST, Besty JH. 坎貝爾骨科手術(shù)學(xué). 王巖, 唐佩福, 裴國獻(xiàn), 譯. 11版. 北京: 人民軍醫(yī)出版社, 2009: 843-844.
10. Mullaji AB, Marawar SV. Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review. J Arthroplasty, 2007, 22(8): 1143-1149.
11. Bayley JC, Christie MJ, Ewald FC, et al. Long-term results of total hip arthroplasty in protrusion acetabuli. J Arthroplasty, 1987, 2(4): 275-279.
12. Leunig M, Nho SJ, Turchetto L, et al. Protrusio acetabuli: new insights and experience with joint preservation. Clin Orthop Relat Res, 2009, 467(9): 2241-2250.
13. Figueras Coll G, Salazar Fernandez de Erenchu J, Rocr Burnoil J. Results of acetabular wiremesh and autograft in protrusio acetabuli. Hip Int, 2008, 18(1): 23-28.
14. 馬金忠, 朱力波, 桑偉林. 全髖關(guān)節(jié)置換術(shù)治療髖臼內(nèi)陷癥. 中國矯形外科雜志, 2008, 16(15): 1136-1137, 1149.
15. Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978-1990. Acta Orthop Scand, 1993, 64(5): 497-506.
16. de Kam DC, Gardeniers JW, Hendriks JC, et al. Cemented polyethylene cups in patients younger than 40 years. Clin Orthop Relat Res, 2009, 467(7): 1753-1764.
17. Mullaji AB, Marawar SV. Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review. J Arthroplasty, 2007, 22(8): 1143-1149.
18. Lakemeier S, Aurand G, Timmesfeld N, et al. Results of the cementless Plasmacup in revision total hip arthroplasty: a retrospective study of 72 cases with an average follow-up of eight years. BMC Musculoskeletal Disord, 2010, 11: 101.
  1. 1. Van De Velde S, Fillman R, Yandow S. The aetiology of protrusio acetabuli. Literature review from 1824 to 2006. Acta Orthop Belq, 2006, 72(5): 524-529.
  2. 2. Lundby R, Kirkhus E, Hald J, et al. CT of the hips in the investigation of protrusio acetabuli in Marfan syndrome. A case control study. Eur Radiol, 2011, 21(7): 1485-1491.
  3. 3. Dunlop CC, Jones CW, Maffulli N. Protrusio Acetabuli. Bull Hosp Jt Dis, 2005, 62(3-4): 105-114.
  4. 4. Ries MD. Total hip arthroplasty in acetabular protrusio. Orthopedics, 2009, 32(9): 666-668.
  5. 5. Vann MA, Onyike A, Gentry SW, et al. Atraumatic acetabular fracture in secondary protrusio acetabuli: a case report. J Surq Orthop Adv, 2007, 16(2): 93-97.
  6. 6. Sathappan SS, Strauss EJ, Ginat D, et al. Surgical challenges in complex primary total hip arthroplasty. Am J Orthop (Belle Mead NJ), 2007, 36(10): 534-541.
  7. 7. 童培健, 王興中, 肖魯偉. 人工全髖關(guān)節(jié)置換術(shù)中偏心距重建對髖關(guān)節(jié)功能的影響. 中華骨科雜志, 2007, 27 (11): 820-822.
  8. 8. 毛遠(yuǎn)青, 孫月華, 王友, 等. 髖臼內(nèi)陷癥的全髖關(guān)節(jié)置換術(shù). 中華骨科雜志, 2011, 31(2): 143-148.
  9. 9. Canale ST, Besty JH. 坎貝爾骨科手術(shù)學(xué). 王巖, 唐佩福, 裴國獻(xiàn), 譯. 11版. 北京: 人民軍醫(yī)出版社, 2009: 843-844.
  10. 10. Mullaji AB, Marawar SV. Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review. J Arthroplasty, 2007, 22(8): 1143-1149.
  11. 11. Bayley JC, Christie MJ, Ewald FC, et al. Long-term results of total hip arthroplasty in protrusion acetabuli. J Arthroplasty, 1987, 2(4): 275-279.
  12. 12. Leunig M, Nho SJ, Turchetto L, et al. Protrusio acetabuli: new insights and experience with joint preservation. Clin Orthop Relat Res, 2009, 467(9): 2241-2250.
  13. 13. Figueras Coll G, Salazar Fernandez de Erenchu J, Rocr Burnoil J. Results of acetabular wiremesh and autograft in protrusio acetabuli. Hip Int, 2008, 18(1): 23-28.
  14. 14. 馬金忠, 朱力波, 桑偉林. 全髖關(guān)節(jié)置換術(shù)治療髖臼內(nèi)陷癥. 中國矯形外科雜志, 2008, 16(15): 1136-1137, 1149.
  15. 15. Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92,675 operations performed 1978-1990. Acta Orthop Scand, 1993, 64(5): 497-506.
  16. 16. de Kam DC, Gardeniers JW, Hendriks JC, et al. Cemented polyethylene cups in patients younger than 40 years. Clin Orthop Relat Res, 2009, 467(7): 1753-1764.
  17. 17. Mullaji AB, Marawar SV. Primary total hip arthroplasty in protrusio acetabuli using impacted morsellized bone grafting and cementless cups: a medium-term radiographic review. J Arthroplasty, 2007, 22(8): 1143-1149.
  18. 18. Lakemeier S, Aurand G, Timmesfeld N, et al. Results of the cementless Plasmacup in revision total hip arthroplasty: a retrospective study of 72 cases with an average follow-up of eight years. BMC Musculoskeletal Disord, 2010, 11: 101.