CEMENTLESS TOTAL HIP ARTHROPLASTY FOR TREATMENT OF Crowe TYPE III DEVELOPMENTAL DYSPLASIA OF HIP IN ADULTS

目的: 探讨生物型人工全髋关节置换术（total hip arthroplasty，THA）治疗Crowe Ⅲ型成人髋关节发育不良（developmental dysplasia of hip，DDH）的疗效。. 方法: 2013年9月-2015年9月，收治50例（51髋）Crowe Ⅲ型DDH患者。男20例（20髋），女30例（31髋）；年龄19～55岁，平均39岁。左髋34例、右髋15例，双髋1例。患者均伴明显跛行步态，患侧髋关节疼痛明显。临床症状出现至入院就诊时间为10～47个月，平均26个月。患髋“4”字征、Trendenleburg征均呈阳性，髋关节Harris评分为（38.9±7.1）分。单髋患者双下肢长度相差2.5～4.0 cm，平均3.3 cm。患者均采用生物型假体行THA，其中28例（28髋）行自体股骨头结构性植骨。. RESULTS: After operation, the incision healed by first intention. Only 2 patients (2 hips) had femoral nerve palsy, and 7 patients (7 hips) had leg swelling, which were cured after symptomatic treatment. All the patients were followed up 6-18 months (mean, 10 months). The sign of limp walking was improved after operation, hip pain was relieved in 46 patients (46 hips) and only 4 patients (5 hips) still had mild pain. The X-ray films showed bony healing at 3-6 months (mean, 5 months) after operation. At last follow-up, the patients had equal limb length with the discrepancy less than 1 cm (mean, 0.4 cm). At last follow-up, the Harris score was significantly increased to 91.2±2.8 (t=-79.77, P=0.00). CONCLUSIONS: The cementless THA is an effective method to treat Crowe type Ⅲ DDH in adults.