Objective To analyze the methods of offside reconstruction in total hip arthroplasty (THA) for severe osteoarthritis.
Methods Between July 2009 and June 2011,18 cases (18 hips) of severe osteoarthritis of the hip were treated by THA,including 14 males and 4 females with a mean age of 55.4 years (range,47-72 years).The disease duration was 11-74 months (mean,33.6 months).The left hip was involved in 11 cases and the right hip in 7 cases.The hip Harris score was 34.6±5.3.The lower limb discrepency was observed in 15 cases.Thomas sign,Patrick sign,and Trendelenburg sign were positive in all cases.All patients received THA; during operation,standard femoral neck osteotomy was performed and the correct rotation center was chosen to reconstruct offside.
Results All the incisions healed primarily.Common peroneal nerve injury occurred in 1 case and was cured after symptomatic treatment for 3 months,and the other patients had no complication.The mean follow-up period was 43.5 months (range,30-53 months).All patients achieved pain relief,and returned to normal gait.The X-ray films showed no dislocation of the hip or prosthetic loosening.Lower limb discrepency was observed in 6 cases.The mean offside difference between normal and ipsilateral side was 0.4 mm (range,0.1-0.7 mm).At last follow-up,the hip Harris score was 83.0±7.1,showing significant difference when compared with preoperative score (t=-22.96,P=0.01); the hip range of motion was significantly increased when compared with preoperative one (P<0.05).
Conclusion The offside reconstruction can accurately be carried out by making precise template and vernier caliper measurement,selecting suitable prosthesis preoperatively,maintaining the proper femoral calcar length,adjusting the length of the neck and neck-shaft angle,releasing the soft tissue reasonably during THA for severe osteoarthritis,and the short-term effectiveness is satisfactory.
Citation：
BANZhaonan, HUANGFuguo, GUQishan, XUBing, LIYongkui, LIZhengjiang. METHODS OF OFFSIDE RECONSTRUCTION IN TOTAL HIP ARTHROPLASTY FOR SEVERE OSTEOARTHRITIS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(8): 947-950. doi: 10.7507/1002-1892.20140208
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Copyright © the editorial department of Chinese Journal of Reparative and Reconstructive Surgery of West China Medical Publisher. All rights reserved
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孙远新.髋关节周围软组织重建对THA术后稳定性的研究.中国伤残医学,2013,21(6):101-102.
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陈群群,周伟君,周驰,等.初次全髋关节置换术中影响股骨偏心距重建的相关因素分析.实用骨科杂志,2012,18(7):604-607.
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郝思春,蒋健农,陈俊,等.股骨偏心距对全髋关节置换术中应力水平影响的三维有限元分析.中华关节外科杂志(电子版),2013,7(5):700-704.
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陈宜,吴宇黎,祝云利,等.股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用.中华骨科杂志,2013,33(9):901-905.
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郑之和,董军峰,李新志,等.全髋关节置换术后双下肢不等长的预防和处理.中国修复重建外科杂志,2008,22(6):662-664.
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蒋健农,郝思春,王勇,等.股骨偏心距对老年全髋关节置换术中应力水平影响的三维有限元分析.中华创伤杂志,2012,28(9):813-817.
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Trousdale RT,Morrey BF.Leg length inequality//Morrey BF.Reconstructive surgery of the joint.2nd ed.New York:Churchill Livingstone,1995:1297-1306.
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任明安,徐国红,王利宏,等.术中测量股骨假体肩部与大转子顶点垂直高度预防全髋关节置换术后下肢不等长.浙江创伤外科,2012,17(5):577-579.
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郭志辉,叶亚罡.人工全髋关节置换术双下肢不等长的临床分析及对策.中国实用医药,2013,8(31):119-120.
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刘玉平,周勇刚,俞光荣.软组织平衡在全髋关节置换术中的重要性.中华关节外科杂志(电子版),2009,3(6):769-773.
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- 1. 付稳,徐耀增,耿德春,等.采用锥形股骨近端组配柄假体行全髋关节置换术的早期疗效.中华创伤杂志,2013,29(12):1138-1142.
- 2. 陆鸣,沈书明,马明.股骨偏心距重建与相关手术要素(附24例分析).实用临床医药杂志,2009,13(3):75,77.
- 3. 孙远新.髋关节周围软组织重建对THA术后稳定性的研究.中国伤残医学,2013,21(6):101-102.
- 4. 陈群群,周伟君,周驰,等.初次全髋关节置换术中影响股骨偏心距重建的相关因素分析.实用骨科杂志,2012,18(7):604-607.
- 5. 郝思春,蒋健农,陈俊,等.股骨偏心距对全髋关节置换术中应力水平影响的三维有限元分析.中华关节外科杂志(电子版),2013,7(5):700-704.
- 6. 马俊,黄泽宇,沈斌,等.单一颈长假体对国人全髋置换术后下肢长度的影响.中国骨与关节外科,2013,6(5):416-420.
- 7. 陈宜,吴宇黎,祝云利,等.股骨颈组配式假体在全髋关节置换术后偏心距重建中的作用.中华骨科杂志,2013,33(9):901-905.
- 8. 夏红,王万春,唐新桥,等.人工髋关节置换术后并发症临床分析.医学临床研究,2006,23(9):1436-1438.
- 9. 郑之和,董军峰,李新志,等.全髋关节置换术后双下肢不等长的预防和处理.中国修复重建外科杂志,2008,22(6):662-664.
- 10. 蒋健农,郝思春,王勇,等.股骨偏心距对老年全髋关节置换术中应力水平影响的三维有限元分析.中华创伤杂志,2012,28(9):813-817.
- 11. Trousdale RT,Morrey BF.Leg length inequality//Morrey BF.Reconstructive surgery of the joint.2nd ed.New York:Churchill Livingstone,1995:1297-1306.
- 12. 任明安,徐国红,王利宏,等.术中测量股骨假体肩部与大转子顶点垂直高度预防全髋关节置换术后下肢不等长.浙江创伤外科,2012,17(5):577-579.
- 13. 郭志辉,叶亚罡.人工全髋关节置换术双下肢不等长的临床分析及对策.中国实用医药,2013,8(31):119-120.
- 14. 刘玉平,周勇刚,俞光荣.软组织平衡在全髋关节置换术中的重要性.中华关节外科杂志(电子版),2009,3(6):769-773.
