摘要目的 观察全髋关节置换治疗银屑病关节炎髋关节病变的效果.方法 2005年1月至2016年12月北京协和医院骨科对15例(20髋)银屑病关节炎髋关节病变患者行全髋关节置换术,置换前患者日常活动均明显受限,Harris 评分平均25.2分,髋关节总活动度平均39.6°.所用假体均为生物型,摩擦界面为陶瓷对陶瓷.结果 全部病例获得随访,随访时间平均35.7(6~63)个月.所有患者术后均达到了生活基本自理的程度,Harris评分平均83.2分,其中优15髋(12例),良3髋(2例),可2髋(1例),差0髋,优良率90.0%,髋关节总活动度平均为175.0°.末次随访20髋均无感染、假体松动和移位出现,1髋术后即发现大粗隆撕脱骨折,随访中发现形成关节内游离体,但未影响髋关节功能.结论 在把握良好手术时机的前提下,全髋关节置换是治疗银屑病关节炎髋关节病变安全、有效的手段,可以恢复关节功能,明显改善患者生活质量.

abstractsObjective To evaluate the clinical efficacy of Total hip arthroplasty(THA)in treating the hip joint involvement of Psoriatic arthritis(PsA).Methods From January 2005 to December 2016,a total of 15 PsA patients(20 hip joints)underwent THA in Department of Orthopaedics, Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College.All the patients had obvious restriction in daily life before operation.The mean Harris score was 25.2 averagely and the mean total range of the hip joint movement was 39.6°before surgery.All the prosthesis were biotype and ceramic to ceramic.Results All patients were followed up with an average of 35.7 months and could take care of themselves.The Harris score of hip joint was 83.2 averagely,including 15 hips excellent,3 good, and 2 passable,with an excellent and good rate of 90%.The mean total range of the hip joint movement was 175°after surgery.There was no infection, nerve injury or loosening of the prosthesis.1 hip appeared avulsion fracture of greater trochanter of femur,and the joint function was satisfying at the last time of follow-up.Conclusion THA is an effective method in treating affected hip joint of PsA.It can restore the hip function and improve the life quality of the PsA patients.