RA伴骨质疏松患者行同期双侧髋关节置换疗效分析

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Abstract Objective To investigate the clinical outcomes of Synergy prosthesis in simultaneous bilateral total hip arthroplasty(THA) for advanced RA and young patients.Methods young patients(5 males and 8 females，ranging in age from 39 to 48 years old，with an average of 42.5 years old)including 26 hips with rheumatoid arthritis were treated with Synergy prosthesis from January 2010 to December 2014.The hip RA duration was 12.7 years in average.The acetabular prostheses were all biological prosthesis，with the ceramic lining in all cases the ceramic femoral head was used in all the cases.The posterior-lateral hip incision was adopted in the surgery.The follow-up was carried out in 3，6，12 months after the surgery，and later once a year.The Harris score system and Engh score of bone in growth of femoral side described were used to assess the joint function of the patients before and after the surgery.Results All the patients were followed up with an average time of 3.8 years(2.5 to 5.3 years).The Harris score increased from preoperative(44.00±10.00) to (92.50±15.00) at the end of the follow-up，There were statistically significant differences in before and after surgery groups(P＜0.01).The joint activity by the (46.00±8.00)°(0°～60.00°)to improve the final follow-up (105.50±18.00)°(90.00°～130.00°)in the follow-up，There were statistically significant differences before and after surgery groups(P＜0.01).All the incisions healed well and there were no complications such as femoral fracture，infection，dislocation and neurovascular injuries.All the joints had good or excellent clinical results.Conclusion The simultaneous bilateral of THA had the advantages in rapid recovery of hip function for the advanced RA and osteoporosis patients，but it required precise preoperative assessment and precise operation.

Key words： arthroplasty replacement rheumatoid arthritis simultaneous bilateral

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