Zweymüller spiral acetabular prosthesis for treating developmental dysplasia of the hip in adults

doi:10.3969/j.issn.2095-4344.2015.39.008

Abstract

Abstract:

BACKGROUND: Spiral acetabular prosthesis has good stability during total hip arthroplasty.
OBJECTIVE: To observe the early therapeutic effect of Zweymüller spiral acetabular prosthesis in total hip arthroplasty for patients with developmental dysplasia of the hip.
METHODS: Totally 38 patients (48 hips) with developmental dysplasia of the hip received total hip arthroplasty with Zweymüller spiral acetabular prosthesis from January 2011 to June 2013 were selected. The clinical effect was observed after the operation.
RESULTS AND CONCLUSION: A total of 38 patients were followed up for 21-46 months (averagely 42.3 months). One case suffered from deep venous thrombosis. Harris scores and Charnely scores apparently increased after surgery compared with that before surgery. The mean length of the osteotomy was 2.42±0.48 cm, and the mean extended length of the affected limb was 4.58±1.15 cm. X-ray films showed that there was no disunion of the osteotomy, no subsidence and loosening of prosthesis. The position of the acetabulum was suitable. The healing time of bone graft was 3-11 months (averagely 5.3 months). The coverage of the acetabular component was 92.5%, with a good initial stability, and the excellent rate of the operation was 90%. The satisfaction rate of patients was 84%. These results indicate that the Zweymüller spiral acetabular prosthesis has the advantages of reasonable design, good initial stability, low loosening rate and high satisfaction degree. However, the number of cases of this study was relatively small, the follow-up time was short, and only the short-term effect was evaluated. Thus, the midterm and long-term effects need to be observed by the follow-up evaluation.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Hip Joint, Hip Dislocation, Congenital, Acetabulum, Hip Prosthesis

CLC Number:

R318

Wu Jian, Wang Bing, Yao Li. Zweymüller spiral acetabular prosthesis for treating developmental dysplasia of the hip in adults[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2015.39.008.

Figures/Tables 4

References

[1] 吴红辉,廖怀章,蒋勇.全髋关节置换术治疗成人发育性髋关节发育不良的临床研究[J].中国医学工程,2014(3):62,64.
[2] 雒文彬.全髋关节置换治疗成人发育性髋关节发育不良20例随访分析[D].长春:吉林大学,2014.
[3] 周丹.成人发育性髋关节发育不良的诊断及治疗进展[J].中外医学研究,2013(29):153-155.
[4] 孙学斌.Zweymüller非骨水泥型髋关节假体治疗髋关节疾病疗效分析[D].乌鲁木齐:新疆医科大学,2006.
[5] Garcia-Cimbrelo E, Cruz-Pardos A, Madero R, et al. Total hip arthroplasty with use of the cementless Zweymüller Alloclassic system. A ten to thirteen-year follow-up study. J Bone Joint Surg Am. 2003;85-A(2):296-303.
[6] 李文波,张文明,白国昌,等.人工全髋关节置换术治疗成人Crowe Ⅳ型先天性髋关节发育不良伴脱位[J].中国修复重建外科杂志, 2013(10):1153-1156.
[7] Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am. 1979;61(1):15-23.
[8] 高东宸,张丽雅.药物不良反应监测指南[M].北京:中国医药科技出版社,1996:171.
[9] 花龙.Zweymüller非骨水泥型假体全髋人工关节置换治疗成人高位发育性髋脱位的中期随访[D].乌鲁木齐:新疆医科大学,2013.
[10] 吴海山,冯明光.髋膝关节置换术后疗效评估体系[J].中华骨科杂志,2004,24(8):509-512.
[11] 祝天经.人工膝关节置换手术的疗效评定及功能评定[J].现代康复.2001,5(3):1-13.
[12] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:134-135.
[13] 马春敏,沈庆平,戴文安.视觉模拟评分法(VAS)对舌向集中牙合与半解剖牙合全口义齿满意度的比较研究[J].中国美容医学, 2013, 22(7):756-759.
[14] 陈文革.人工全髋关节置换治疗发育性髋关节发育不良继发晚期骨关节炎的疗效[J].中国老年学杂志,2014(19):5457-5459.
[15] 黄武开,任戈亮,侯勇,等.Zweymüller双锥面螺旋臼治疗Ⅲ、Ⅳ型髋关节发育不良继发骨关节炎早期疗效[J].临床骨科杂志,2013, 16(5):510-512.
[16] 李彪,龚跃昆,张磊,等.生物型全髋关节置换术治疗成人髋关节发育不良[J].中国修复重建外科杂志,2008,22(6):646-648.
[17] 黄文泽,彭昊,方洪松,等.大头陶瓷-陶瓷人工全髋关节置换术治疗成人先天性髋关节发育不良[J].临床骨科杂志,2013,16(2): 151-154.
[18] 温东栋,梁瑞德.发育性髋关节发育不良治疗进展[J].广西中医药大学学报,2015,18(2):94-97.
[19] 魏宝刚,吕龙.成人发育性髋关节发育不良人工全髋关节置换术[J].中国骨科临床与基础研究杂志,2009,1(2):101-104.
[20] 罗毅,丁晓川,侯伟光,等.全髋关节置换术治疗成人严重先天性髋关节发育不良的近期疗效观察[J].四川医学,2015(3):368-370.
[21] 陈涛,杨春喜.人工全髋关节置换术治疗Crowe Ⅳ型先天性髋关节发育不良截骨术的研究进展[J].中国修复重建外科杂志, 2015, (4):444-447.
[22] Jaroszynski G, Woodgate IG, Saleh KJ, et al. Total hip replacement for the dislocated hip. Instr Course Lect. 2001; 50:307-316.
[23] Voigt JD, Mosier MC. Cemented all-polyethylene acetabular implants vs other forms of acetabular fixation: a systematic review and meta-analysis of randomized controlled trials. J Arthroplasty. 2012;27(8):1544-1553.e10.
[24] 刘瑞宇,王坤正,王春生,等.不同程度髋关节发育不良继发骨性关节炎的全髋关节置换术疗效分析[J].中国矫形外科杂志,2008, 16(21):1613-1615.
[25] 张前进,吴昭克,徐福东,等.螺旋臼全髋关节置换术治疗成人发育性髋关节发育不良20例[J].中国中医骨伤科杂志,2010(10): 48-49.
[26] 卞春喜,骆雷锋,袁文旗,等.螺旋臼在成人髋臼发育不良晚期手术治疗中的应用[J].中国卫生产业,2014(8):147.
[27] 林国叶,李平生,黄玉栋.双椎面螺旋臼全髋假体的临床应用与疗效观察[J].中国骨与关节损伤杂志,2009,24(12):1099-1100.
[28] 王中田,冯伯志,侯勇,等.Zweymüller双锥面螺旋臼治疗老年股骨颈骨折[J].临床骨科杂志,2014(4):426-428.
[29] 曹锦,胡丰根.全髋置换术治疗成人髋臼发育不良伴骨性关节炎[J].齐齐哈尔医学院学报,2010,31(19):3052-3053.
[30] Perka C, Fischer U, Taylor WR, et al. Developmental hip dysplasia treated with total hip arthroplasty with a straight stem and a threaded cup. J Bone Joint Surg Am. 2004; 86-A(2):312-319.
[31] Bouras T, Repantis T, Fennema P, et al. Low aseptic loosening and revision rate in Zweymüller-Plus total hip arthroplasty with ceramic-on-ceramic bearings. Eur J Orthop Surg Traumatol. 2014;24(8):1439-1445.
[32] 寇伯龙,袁燕林,吕厚山,等.先天性髋臼发育不良继发骨性关节炎的外科治疗[J].中华外科杂志,200l,39(8):623-625.
[33] Lei P, Hu Y, Cai P, et al. Greater trochanter osteotomy with cementless THA for Crowe type IV DDH. Orthopedics. 2013; 36(5):e601-605.
[34] 吴健,王兵,吴玉玲,等.粗隆下截骨结合Zweymuller假体全髋关节置换术治疗Crowe Ⅳ型髋关节发育不良[J].中华关节外科杂志(电子版),2014(5):608-612.
[35] 任鹏,柴伟,周勇刚,等.人工全髋关节置换治疗CroweⅡ、Ⅲ型发育性髋关节发育不良——非骨水泥臼杯高旋转中心安放的短期随访结果[J].中华骨与关节外科杂志,2015(2):145-150.
[36] Gill TJ, Sledge JB, Müller ME. Total hip arthroplasty with use of an acetabular reinforcement ring in patients who have congenital dysplasia of the hip. Results at five to fifteen years. J Bone Joint Surg Am. 1998;80(7):969-979.
[37] Garvin KL, Bowen MK, Salvati EA, et al. Long-term results of total hip arthroplasty in congenital dislocation and dysplasia of the hip. A follow-up note. J Bone Joint Surg Am. 1991;73(9): 1348-1354.
[38] Dorr LD, Tawakkol S, Moorthy M, et al. Medial protrusio technique for placement of a porous-coated, hemispherical acetabular component without cement in a total hip arthroplasty in patients who have acetabular dysplasia. J Bone Joint Surg Am. 1999;81(1):83-92.
[39] 张媺,白鹏程,江建平,等.螺旋型髋臼与压配型髋臼的临床应用分析[J].中国组织工程研究与临床康复,2012,16(22):4031-4034.
[40] Li X, Guan G, Li J. Reconstruction of hip center in total hip arthroplasty for developmental dysplasia of hip. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012;26(9):1037-1040.
[41] 陶崑,王琦,曾炳芳.Zweymüller髋关节系统[J].国际骨科学杂志, 2006,27(6):380-381.
[42] 张绍安,魏新军,李智浩,等.双锥面螺旋臼在髋臼翻修术中的应用[J].中国矫形外科杂志,2013,21(12):1240-1243.
[43] 郭予立,史占军,林本丹,等.双锥面螺旋臼全髋关节系统治疗股骨头缺血性坏死中远期疗效评估[J].广东医学,2013,34(3):418-420.
[44] 王继芳.人工关节翻修面临的挑战和机遇[J].中华骨科杂志,2001, 21(6):327.
[45] 刘康,何智勇,余楠生,等.人工髋关节翻修术中使用同种异体骨[J].临床骨科杂志,2004,7(4):388-389.
[46] 寇伯龙,吕厚山,林剑浩,等.双锥面螺旋臼及加长矩型柄在髋关节翻修术中的应用[J].中华骨科杂志,2003,23(12):743-746.
[47] 曲华正,张伟,孙水,等.双锥面螺旋臼假体置换治疗类风湿性髋关节炎24例[J].中国组织工程研究与临床康复,2009,13(52): 10231- 10235.
[48] 黄武开,侯勇,冯伯志,等.Zweymüller双锥面螺旋臼联合PLUS-SL微创柄治疗股骨头坏死继发骨关节炎疗效分析[J].蚌埠医学院学报,2014(9):1198-1200.
[49] 史占军,金大地,景宗森,等.强直性脊柱炎髋关节骨性强直的功能重建[J].中华骨科杂志,2002,22(5):267-271.
[50] Harris P, Nagy S, Vardaxis N. Mosby's Dictionary of Medicine Nursing & Health professions.7th ed. St. Louis: Mosby Elsevier. 2006:115-116,335,520,1454,1849,1949.
[51] 郭予立.Zweymüller非骨水泥型全髋关节置换术后5-10年随访研究[D].广州:南方医科大学,2008.
[52] Clarke MT, Green JS, Harper WM, et al. Screening for deep-venous thrombosis after hip and knee replacement without prophylaxis. J Bone Joint Surg Br. 1997;79(5):787-791.
[53] 邱贵兴,杨庆铭,余楠生,等.低分子肝素预防髋、膝关节手术后下肢深静脉血栓形成的多中心研究[J].中华骨科杂志,2006,26(12): 819-822.
[54] Lassen MR, Ageno W, Borris LC, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty. N Engl J Med. 2008;358(26):2776-2786.
[55] 钱文伟,翁习生,常晓,等.人工髋关节置换后深静脉血栓形成影响因素的回顾分析[J].中国组织工程研究与临床康复,2012,16(4): 622-625.
[56] 陈戬宏,息子龙,袁柱.全髋关节置换后对深静脉血栓的综合预防[J].中国组织工程研究,2015,19(17):2642-2647.
[57] 俞学军,徐家法,储修峰,等.肝胆外科手术切口感染的多因素分析及治疗对策[J].中华医院感染学杂志,2012,22(10):2080-2081,2115.
[58] 吕亮,王福生,卢敏,等.人工髋关节置换术后感染的危险因素分析及预防[J].中华医院感染学杂志,2013,23(6):1334.
[59] 杜英勋,吴汝平,闫青,等.人工髋关节置换术后感染的危险因素与预防[J].中华医院感染学杂志,2015(9):2094-2096.
[60] Becker DA, Gustilo RB. Double-chevron subtrochanteric shortening derotational femoral osteotomy combined with total hip arthroplasty for the treatment of complete congenital dislocation of the hip in the adult. Preliminary report and description of a new surgical technique. J Arthroplasty. 1995; 10(3):313-318.
[61] 吴斌.成人先天性髋关节发育不良的人工全髋关节置换治疗观察[J].中外医学研究,2012,10(7):36-37.
[62] 魏威,寇伯龙,王小梅,等.螺旋臼全髋关节置换术治疗发育性髋关节发育不良[J].中华关节外科杂志(电子版),2008,2(4):393-398.