生物骨科材料与临床研究2025，Vol.22Issue(1)：24-27,4.DOI:10.3969/j.issn.1672-5972.2025.01.005
类风湿性关节炎继发严重髋臼内陷合并股骨骨折的全髋关节置换术
Total hip arthroplasty for severe acetabular invagination with femoral fracture secondary to rheumatoid arthritis
张鹏 1陈果 1毕梦娜1
作者信息
- 1. 四川省骨科医院髋膝关节病科,四川 成都,610041
- 折叠
摘要
Abstract
Objective To investigate the clinical effect of total hip arthroplasty and internal fixation in the treatment of severe acetabular invagination with femoral fracture secondary to rheumatoid arthritis.Methods All 16 cases of femoral head necrosis combined with femoral fracture treated in Sichuan Province Orthopedic Hospital from July 2017 to September 2022 were selected as the subjects of study.All patients underwent one-stage total hip arthroplasty combined with cable plate internal fixation.The operation time,intraoperative blood loss and postoperative complications were recorded.The distance from the center point of the femoral head to Kohler's line before and after surgery,as well as the height of the center of rotation of the femoral head were measured.The joint function was evaluated by the Harris score.Results Patients were followed up for 12-58 months,with an average of(31.2±3.2)months.The operation time was 56-135 min,with an average of(76.3±8.8)min.The intraoperative blood loss was 200-920 mL,with an average of(305.0±44.2)mL.Postoperative complications occurred in 5 cases.X-ray showed that all the fractures healed 6 months after operation.Comparison of distance from the center point of the femoral head to Kohler's line before and after surgery,the difference was statistically significant(P<0.05).Comparison of preoperative and postoperative height of femoral head rotation center,the difference was not statistically significant(P>0.05).The Harris score at 12 months after operation was better than that before operation,the difference was statistically significant(P<0.05).No prosthesis loosening was found in any of the patients at the last follow-up.Conclusion For patients with rheumatoid arthritis who have secondary severe acetabular dysplasia combined with femoral fractures,a one-stage revision of the total hip arthroplasty combined with cable plate internal fixation is performed.It can effectively improve acetabular dysplasia,reconstruct the acetabular rotation center,and effectively improve joint function.The efficacy is clear,making it an ideal method for treating this type of disease.关键词
全髋关节置换术/内固定术/类风湿性关节炎/股骨骨折Key words
Total hip arthroplasty/Internal fixation/Rheumatoid arthritis/Femoral fracture分类
医药卫生引用本文复制引用
张鹏,陈果,毕梦娜..类风湿性关节炎继发严重髋臼内陷合并股骨骨折的全髋关节置换术[J].生物骨科材料与临床研究,2025,22(1):24-27,4.
