[1]吴文锐,罗斯敏,刘宁,等.全髋关节置换术对强直性脊柱炎髋关节病变患者工作能力及功能恢复的影响[J].南方医科大学学报,2018,(07):879.
点击复制

全髋关节置换术对强直性脊柱炎髋关节病变患者工作能力及功能恢复的影响()
分享到:

《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2018年07期
页码:
879
栏目:
出版日期:
2018-06-30

文章信息/Info

Title:
Functional outcomes of patients receiving total hip arthroplasty for ankylosing spondylitis
作者:
吴文锐罗斯敏刘宁查振刚
关键词:
强直性脊柱炎髋骨性强直全髋关节置换术
Keywords:
ankylosing spondylitis ankylosed hip total hip arthroplasty
摘要:
目的探讨全髋关节置换术治疗强直性脊柱炎髋关节病变的近期临床疗效及对患者工作能力恢复的影响。方法2013年 3月~2016年4月对75例(92髋)强直性脊柱炎伴髋骨性强直患者行生物型人工全髋关节置换术,并进行12~24月的随访,通过 对手术前后患髋VAS疼痛评分、关节总活动度、整体功能改善情况、就业情况进行比较,根据Harris评分系统、BAFSI、BASDAI 评分进行评分。结果所有患者术后末次随访的关节总活动度、临床症状以及髋关节功能均得到极大改善。VAS疼痛评分由术 前(6.51±1.32)分降至(2.47±0.38)分,髋关节Harris评分由术前(22.51±3.32)分,增加至术后2周(89.17±2.52)分,髋关节总活动 度由术前0°提高到末次随访时(171.50±30.30)°,BAFSI评分由术前(6.21±2.6)末次随访时(2.31±1.2),差异有统计学意义(P< 0.05)。其中优42髋,良38髋,可12髋,优良率达87%。术后6个月和12个月,75例患者中,6例和32例恢复正常工作。所有病 例术后均无血管神经损伤,X-ray未见感染、脱位,其中1例术后4个月因术髋疼痛拍片见假体松动,5例发生异位骨化。其中 BrookerⅠ级3例,Ⅱ级2例,未见Ⅲ、Ⅳ级异位骨化。结论生物型人工全髋关节置换术是治疗强直性脊柱炎伴髋骨性强直的有 效手段。关节置换术后可帮助患者早期恢复工作,提高生活及工作质量,近期效果良好。
Abstract:
Objective To assess the functional outcomes of patients undergoing total hip arthroplasty for ankylosing spondylitis (AS). Methods Between March, 2013 and May, 2016, 75 AS patients with ankylosed hip (involving 92 hips) underwent unilateral biological artificial total hip arthroplasty. The patients were followed up for 12-24 months and the changes in VAS score of the affected hip were evaluated. The changes in the range of motion (ROM) of hip, employment, BASFI and BASDAI score, and Harris score were analyzed after the operations. Results Significant improvements in general joint mobility, clinical symptoms and hip joint functions were achieved in all the patients. The average VAS score was significant reduced from 6.51± 1.32 preoperatively to 2.47 ± 0.38 after the operation. Significant improvements were also achieved after the operation in the average Harris hip score (from 22.51±3.32 to 89.17±2.52), the total ROM ( from 0 to 171.50±30.30), and mean BASFI score (from 6.2±2.6 to 2.3±1.2; all P<0.05). At the final follow up, 42 hips showed excellent outcomes, 38 hips had good outcomes, and 12 hips had acceptable outcomes, with a good outcome rate of 87%. By 6 and 12 months after the operation, 6 and 32 of the 75 patients returned to work. No neurovascular injuries, infections or dislocations was found in the patients during the follow-up; 1 patient had prosthesis loosening found by X-ray ordered for complaint of pain in the affected hip 4 months postoperatively. Five patients had heterotopic ossifications, including 3 grade Ⅰ hips and 2 grade Ⅱ hips according to the Brooker grading system. Conclusion Biological artificial total hip arthroplasty is effective for treatment of ankylosing spondylitis with hip stiffness with good functional outcomes of the hip joint.

相似文献/References:

[1]李玲,董光富,张晓,等.阿德福韦酯致Fanconi综合征和低磷性骨软化症并进行性肌无力1例[J].南方医科大学学报,2011,(11):1956.
[2]杨佩,王春生,王坤正,等.强直性脊柱炎全髋关节置换术股骨假体的选择[J].南方医科大学学报,2005,(12):1468.
 YANG Pei,WANG Chun-sheng,WANG Kun-zheng,et al.Selection of femoral prosthesis in total hip replacement for ankylosing spondylitis[J].Journal of Southern Medical University,2005,(07):1468.
[3]陈芳妮,李绍林,张晓东,等.强直性脊柱炎骨盆骨髓脂肪沉积的磁共振成像分析[J].南方医科大学学报,2014,(02):256.
[4]任洁,周毅,吴会霞,等.双能CT检查在痛风性关节炎中的应用价值[J].南方医科大学学报,2015,(03):384.
[5]廖志鹏,汪青春,谢秋屏,等.强直性脊柱炎临床分期探讨[J].南方医科大学学报,2006,(08):1176.
 LIAO Zhi-peng,WANG Qing-chun,XIE Qiu-ping,et al.Clinical staging of ankylosing spondylitis[J].Journal of Southern Medical University,2006,(07):1176.

更新日期/Last Update: 1900-01-01