目的:探讨全髋关节置换术的Crowe Ⅲ-Ⅳ型发育性髋关节发育不良(developmental dysplasia of the hip，DDH)患者的满意度及造成不满意的相关因素。方法:回顾性分析2013年3月至2018年3月行全髋关节置换术的169例Crowe Ⅲ-Ⅳ型DDH患者，通过微信进行调查问卷，调查患者对手术总体满意度、10项日常功能满意度和患者认为对自己日常生活影响比较大的前5个问题。手术前后采用髋关节Harris评分进行功能评价。结果:收到完整调查问卷145份，所有患者获随访，时间1～5(3。23±1。22)年。145例患者分成两组，其中对手术疗效满意的118例，不满意的27例，手术总体满意率81。38％(118/145)。患者认为对生活影响比较大的前5个问题分别是术后髋部疼痛，肢体明显不等长、行走、上下楼梯、蹲起。两组术前Harris评分比较，差异无统计学意义(P＞0。05)，不满意组术后Harris评分较低。术后髋关节疼痛、肢体不等长是影响手术不满意的直接因素。结论:采用全髋关节置换术治疗CroweⅢ-Ⅳ型DDH患者手术难度大;术后髋关节疼痛(轻度以上)，肢体不等长(＞2 cm)是术后不满意的独立危险因素。
Analysis of dissatisfaction and related factors following total hip arthroplasty in patients with Crowe type Ⅲ-Ⅳ de-velopmental dysplasia of the hip
Objective To investigate the satisfaction of patients with Crowe Ⅲ-Ⅳ developmental dysplasia of the hip(DDH)after total hip arthroplasty and the related factors.Methods A retrospective study included 169 patients with Crowe type Ⅲ-Ⅳ DDH who underwent total hip arthroplasty between March 2013 and March 2018.Patients were surveyed through WeChat,covering overall satisfaction with the operation,satisfaction with ten daily functions,and the top five questions per-ceived to have a great impact on daily life.Preoperative and postoperative hip function was evaluated by Harris score.Results One hundred and forty-five questionnaires were received,with a follow-up period ranging from 1 to 5 years with an average of(3.23±1.22)years.Among these patients,118 patients were satisfied with the surgical outcomes,while 27 patients were dissat-isfied,with the overall satisfaction rate of 81.38％(118/145).The top five problems affecting patient life were postoperative hip pain,limb length discrepancy,walking,stair climbing,and squatting.There were no statistical differences in age,sex,body mass index,preoperative Harris scores(P＞0.05).However,the dissatisfied group had lower postoperative Harris scores.Post-operative hip pain and limb length discrepancy were identified as direct factors contributing to postoperative surgical dissatis-faction.Conclusion Total hip arthroplasty for patients with Crowe type Ⅲ-Ⅳ DDH is challenging.Postoperative hip pain(mild or severe)and limb length discrepancy(＞2 cm)are independent risk factors for postoperative dissatisfaction.
High dislocatedDevelopmental dysplasia of the hipCrowe Ⅲ-ⅣTotal hip arthroplsatySatisfaction
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