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[1]钱玉,陈东阳,宋凯,等.迟发性脊椎骨骼发育不良并渐进性关节病行全髋关节置换的临床研究[J].医学研究与战创伤救治(原医学研究生学报),2018,20(01):1-5.[doi:10.3969/j.issn.1672-271X.2018.01.001]
　QIAN Yu,CHEN Dong-yang,SONG Kai,et al.A clinical study on total hip arthroplasty caused by progressive pseudorheumatoid dysplasia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(01):1-5.[doi:10.3969/j.issn.1672-271X.2018.01.001]
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迟发性脊椎骨骼发育不良并渐进性关节病行全髋关节置换的临床研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年01期
页码:
1-5
栏目:
出版日期:
2018-01-22

文章信息/Info

Title:
A clinical study on total hip arthroplasty caused by progressive pseudorheumatoid dysplasia
作者:
钱玉; 陈东阳; 宋凯; 戴进; 严文津; 蒋青
作者单位：210008南京，南京大学医学院附属鼓楼医院运动医学与成人重建外科（钱玉、陈东阳、宋凯、戴进、严文津、蒋青）
Author(s):
QIAN Yu; CHEN Dong-yang; SONG Kai; DAI Jin; YAN Wen-jin; JIANG Qing
(Department of Sports Medicine and Adult Reconstructive Surgery，Drum Tower Hospital，School of Medicine，Nanjing University，Nanjing 210008， Jiangsu， China)
关键词:
迟发性脊椎骨骼发育不良并渐进性关节病; 髋关节病变; 全髋关节置换; 临床研究
Keywords:
progressive pseudorheumatoid dysplasia;  hip lesions;  total hip replacement;  clinical study
分类号:
R681.1
DOI:
10.3969/j.issn.1672-271X.2018.01.001
文献标志码:
A
摘要:
目的 探讨迟发性脊椎骨骼发育不良并渐进性关节病累及髋关节，行全髋关节置换，手术方案选择、临床疗效及术后并发症。方法 回顾性分析自2009-2012年南京大学医学院附属鼓楼医院收治的3例迟发性脊椎骨骼发育不良并渐进性关节病者，均为女性，3例（5髋）均行全髋关节置换。术前评估全身骨骼系统，了解骨骼畸形情况。术中选择合适假体，调整双下肢长度，重建髋臼，假体均置于真臼位置。术后进行随访，了解假体情况，评估髋关节功能及疼痛缓解程度。结果 3例均获随访，最长随访时间7年，末次随访时，髋关节Harris评分平均94.6分，较术前平均33.4分明显提高，能正常行进并上下楼梯，步态良好。VAS评分均为0分，较术前（平均5.4分）疼痛明显缓解。术后无下肢深静脉血栓形成及血管、神经损伤，随访期间未发生假体松动、脱位及下沉等并发症。结论 迟发性脊椎骨骼发育不良并渐进性关节病累及髋关节者可行全髋置换，能有效缓解关节疼痛，改善功能，提高生活质量。
Abstract:
Objective This paper is to explore the surgical treatment, clinical efficacy and post-operative complications of patients who have had total hip replacements caused by progressive pseudorheumatoid dysplasia.Methods We performed a retrospective analysis on three female patients diagnosed with the progressive pseudorheumatoid dysplasia. They all received total hip arthroplasty (five hips). We evaluated all the changes of bone system and the deformity thoroughly before the operation. We chose appropriate prostheses, adjusted the length of the lower limbs and made sure that all the acetabular components were placed accurately during the operation. The evaluation of the prosthesis, assessment of joint function and the extent of pain relief were conducted after the surgeries.Results All the three patients were followed-up with the longest follow-up visit lasting for 7 years. The average Post-operative Harris score (mean was 94.6) was higher than that of preoperative (mean was 33.4). They were capable of walking up and down stairs, pacing well and taking good care of themselves. The pain in hips was relived obviously (VAS scores were 0), while the average preoperative VAS scores were 5.4 points. There were no post-operative complications such as deep vein thrombosis in lower limbs, vascular, nerve damage or infection. During the follow-up period, there were not any complications of loosening or dislocation or sinking of the prosthesis as well.Conclusion THA could provide good outcomes in patients with progressive pseudorheumatoid dysplasia involving the hip.

参考文献/References:

[1]Chinawa J, Adimora G, Obu H，et al.Clinical presentation of mucopolysaccharidosis typeII (Hunter′s syndrome) [J]. Ann Med Health Sci Res, 2012,2(1):87-90.[2]Grigelioniene G，Geiberger S，Papadogiannakis N，et al.The phenotype range of achondrogenesis 1A [J]. Am J Med Genet A，2013，161A(10):2554-2558.[3]韩金祥.骨骼系统罕见病研究［M］．济南：山东大学出版社，2013：233-236．[4]周勇刚，王岩.全髋关节置换术后并发症是影响患者满意度的最主要原因[J]. 中华关节外科杂志(电子版),2008,2(5): 479-483.[5]李虎，魏威，袁燕林，等.初次全髋关节置换术后6年以上随访的临床疗效分析[J]. 中华关节外科杂志(电子版),2011,5(5): 555-560.[6]胡伟全,王北岳,徐敬,等.生物型臼杯在骨水泥型髋臼假体翻修术中的应用[J].医学研究生学报,2015,28(12):1290-1293.[7]Rothman RH, Cohn JC.Cemented versus cementless total hip arthroplasty[J].Clin Orthop Relat Res，1990 (254):153-169.[8]Takahito Y，Katsuhiko M，Masahiko N，et al. Cementless total hip arthroplasty for patients with rheumatoidarthritis: a more than 10-year follow-up [J]. Eur J Orthop Surg Traumatol,2016,(26):599-603.[9]周定，臧谋圣，胡勇，等.骨水泥与非骨水泥股骨柄在初次全髋关节置换术后疗效的Meta分析[J]. 中华关节外科杂志(电子版),2014,8(5): 635-642.[10]梁志远,郭洪敏,聂志奎.第四代髋关节陶瓷内衬碎裂后翻修[J].实用骨科杂志,2015,21(3):287-288.[11]刘敬锋,冯建民.陶瓷对陶瓷全髋关节置换后的异响问题[J].中国组织工程研究,2013,17(17):3148-3155.[12]魏召劝,孙俊英,查国春,等.采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究[J].中国修复重建外科杂志,2013,27(12):1414-1418.[13]李冬松,忻振凯,曲广运,等.高交联聚乙烯内衬在中国年轻全髋关节置换患者中应用的6年随访结果[J].中华关节外科杂志(电子版),2011,5(5):593-600.[14]孙久一,符培亮.使用大直径陶瓷头全髋关节年轻患者高交联聚乙烯的2年磨损率[J].中国组织工程研究,2014,18(35):5595-5599.[15]Abdel MP，Stryker LS，Trousdale RT，et al.Uncemented acetabular components with femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: a concise follow-up report at a mean of twenty years[J]. J Bone Joint Surg Am,2014,96(22): 1878-1882.[16]张洪，周一新，黄野，等.髋臼内壁截骨术在发育不良髋关节全髋置换髋臼重建中的应用[J]. 中华骨科杂志,2005,25(4): 223-226.[17]陶伟伟,朱建非,张穹,等.股骨头无菌性坏死中高保留骨量技术应用在初次人工髋关节置换的临床疗效[J].东南国防医药,2014,16(2):135-137.[18]于建华，张铁良.全髋关节置换术下肢不等长的处理[J]. 中华骨科杂志,2001,21(5): 4-7.[19]Edeen J，Sharkey PF，Alexander AH，et al.Clinical significance of leg-length inequality after total hip arthroplasty[J]. Am J Orthop (Belle Mead NJ),1995,24(4): 347-351.[20]Turula KB，Friberg O，Lindholm TS，et al. Leg length inequality after total hip arthroplasty[J]. Clin Orthop Relat Res,1986(202): 163-168.[21]Archbold HA，Mockford B，Molloy D，et al. The transverse acetabular ligament: an aid to orientation of the acetabular component during primary total hip replacement: a preliminary study of 1000 cases investigating postoperative stability[J]. J Bone Joint Surg Br,2006,88(7): 883-886.[22]Fujita K，Kabata T，Maeda T，et al. The use of the transverse acetabular ligament in total hip replacement: An analysis of the orientation of the trial acetabular component using a navigation system[J]. Bone Joint J, 2014, 96-B(3): 306-311.[23]刘强,王德国,赵亮. 全膝关节置换术的研究进展[J]. 中国矫形外科杂志,2013,21(16):1625-1628. [24]王玉光,陆芸.踝关节骨关节炎治疗方法的临床回顾[J].中华关节外科杂志(电子版),2016,10(1):77-80.[25]古明晖,张志奇,何爱珊,等.骨盆倾斜角和骶骨倾斜角在合并脊柱疾病的患者行初次全髋关节置换术中的作用[J].中华关节外科杂志(电子版),2013,7(2):134-137.[26]宋凯,张永刚,付君,等.脊柱矫形对强直性脊柱炎胸腰段后凸畸形患者髋关节相关活动能力及生活质量的影响[J].中国脊柱脊髓杂志,2015,25(10):871-882.[27]Mortier GR.The diagnosis of skeletal dysplasias: a multidisciplinary approach[J]. Eur J Radiol,2001,40(3):161-167.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81420108021）
更新日期/Last Update: 2018-01-20