应用全髋关节置换术治疗脊髓灰质炎后遗症期患者髋关节疾病的临床疗效分析
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四川大学华西医院骨科

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Clinical?efficacy of total hip arthroplasty in Patients with Residual Poliomyelitis
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Department of Orthopaedics,West China Hospital,Sichuan University

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    摘要:

    目的:评价全髋关节置换术治疗脊髓灰质炎后遗症期患者髋关节疾病的临床疗效。方法:回顾性分析自2008年1月至2018年5月四川大学华西医院关节外科应用全髋关节置换术治疗的脊髓灰质炎后遗症期髋关节病变13例患者(13髋),对比术前及随访时Harris髋关节功能评分、UCLA活动能力评分、SF-12生命质量评分,分析影像学结果,记录人工关节脱位、假体松动等相关并发症。结果:13例13髋均获得随访,平均随访时间5.6年(2~9年),患者术前患侧髋关节外展角度为(27.69±12.01)°,随访时为(38.46±8.75)°,差异有统计学意义(P<0.05);术前患侧髋关节屈曲角度为(84.62±16.89)°,随访时为(91.54±8.26)°,差异无统计学意义(P>0.05);Harris评分由术前的(51.46±14.96) 分提高至随访时的(84.15±6.07)分,差异有统计学意义(P<0.05);UCLA活动能力评分由术前的(2.62±0.96)分提升至随访时的(6.08±1.26)分,差异有统计学意义(P<0.05);SF-12生活质量评分PCS术前为(25.69±5.59)分,随访时为(54.08±5.09),MCS术前为(42.15±7.32)分,随访时为(51.54±5.29)分,差异均有统计学意义(P<0.05);13髋影像学资料均显示假体稳定性良好,无脱位、假体松动及下沉。结论:全髋关节置换术可以改善脊髓灰质炎后遗症期髋关节病变患者关节功能,提高生活质量,经合理的术前评估、正确的术中处理及科学的术后功能锻炼,患者能够取得较好的临床疗效。

    Abstract:

    Objective:To?evaluate?the clinical?efficacy of total hip arthroplasty in patients with residual poliomyelitis.Methods:Between January 2008 and May 2018,13 THAs were performed in 13 patients with Residual Poliomyelitis,The Harris score,SF-12 score,UCLA activity score and radiological images were recorded and compared before surgery and at the last?follow-up.Result:There was no loss of follow-up,?the mean?follow-up?was?5.6 years.The?range of?abduction?motion?of hip joint was(27.69±12.01)° before surgery and (38.46±8.75)° at final follow-up,?the?difference?was statistically?significan(P<0.05),however,there?was no?significant?difference?in the the?range of?flexion?motion?of hip joint preoperatively?and?at the?time?of the?latest follow-up?(P>0.05);The mean Harris hip score significantly improved from(51.46±14.96) preoperatively to(84.15±6.07)at the latest follow- up(P<0.05);The mean UCLA activity score significantly increased from(2.62±0.96)preoperatively to(6.08±1.26)at the latest follow- up(P<0.005);The mean SF-12 score physical component summary (PCS) and mental component summary (MCS)scores noteworthily improved from (25.69±5.59) and (42.15±7.32) to (54.08±5.09) and (51.54±5.29) respectively (P<0.05).Imaging examination?showed that no?complications?such as?dislocation,?prosthesis?loosening or sinking?happened. Conclusion:THA can improve joint function and life quality of patients with residual poliomyelitis,proper perioperative Evaluation,surgical?treatment and ?scientific postoperative?functional?exercise will allow ?patients with residual poliomyelitis to obtain a better clinical?efficacy.

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  • 收稿日期:2019-05-07
  • 最后修改日期:2019-07-06
  • 录用日期:2019-07-24
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