成人发育性髋关节发育不良人工全髋关节置换术的挑战与应对策略
Challenges and Coping Strategies for Artificial Total Hip Arthroplasty in Adults with Developmental Hip Dysplasia
DOI: 10.12677/acm.2025.15102957, PDF,   
作者: 王克克：济宁医学院临床医学院，山东 济宁；王 鹏：山东第一医科大学第一附属医院(山东省千佛山医院)骨科，山东 济南
关键词: 成人发育性髋关节发育不良；人工全髋关节置换术；髋臼重建；股骨近端解剖异常；Adult Developmental Hip Dysplasia； Artificial Total Hip Arthroplasty； Acetabular Reconstruction； Anatomical Abnormality of the Proximal Femur
摘要: 发育性髋关节发育不良(Developmental Dysplasia of the Hip, DDH)是一种常见先天性髋关节畸形，成人未经干预者可进展为继发性骨关节炎，需行人工全髋关节置换术(Total Hip Arthroplasty, THA)。由于DDH患者存在髋臼骨缺损、股骨畸形及下肢不等长等解剖异常，导致THA面临假体定位困难、关节不稳及远期松动等风险。本文根据临床指南及最新研究，系统总结了三维术前规划对解剖标志识别的价值、多种技术手段在骨缺损修复中的应用、DDH分型指导下的个性化假体选择策略和Crowe IV型DDH患者不同方式的股骨截骨短缩术，以期为成人DDH的THA治疗提供一定的理论支持。
Abstract: Developmental Dysplasia of the Hip (DDH) is a common congenital hip deformity. Untreated cases in adults may progress to secondary osteoarthritis, ultimately requiring Total Hip Arthroplasty (THA). Due to anatomical abnormalities such as acetabular bone defects, femoral deformities, and limb length discrepancy in DDH patients, THA poses challenges, including difficult prosthesis positioning, joint instability, and long-term loosening risks. Based on clinical guidelines and recent research, this paper systematically reviews the value of three-dimensional preoperative planning in identifying anatomical landmarks, the application of various techniques for bone defect reconstruction, personalized prosthesis selection strategies guided by DDH classification, and different femoral shortening osteotomy approaches for Crowe type IV DDH patients. The aim is to provide a theoretical framework for THA treatment in adult DDH cases.
文章引用：王克克, 王鹏. 成人发育性髋关节发育不良人工全髋关节置换术的挑战与应对策略[J]. 临床医学进展, 2025, 15(10): 1869-1876. https://doi.org/10.12677/acm.2025.15102957

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