327例初次人工髋关节置换术失败原因探讨  

An investigation on failure mechanisms of primary 327 hip arthroplasties

作　　者：郭盛君[1] 周一新[1] 张亮[1] 吴坚[1] 吕明[1] 唐竞[1] 张理昂[1] 

机构地区：[1]北京积水潭医院矫形骨科,100035

出　　处：《中华外科杂志》2009年第3期168-171,共4页Chinese Journal of Surgery

摘　　要：目的探讨初次人工髋关节置换术后失败的原因及相关危险因素。方法回顾性分析1988年11月至2008年7月收治的327例人工髋关节初次翻修手术患者的病史、临床和影像学资料以及手术记录。结果以髋关节翻修术作为终止点，共分析327例行初次髋关节翻修术的患者资料，具体失败原因包括假体无菌性松动（226／327，69．1％）、感染（52／327，15．9％）、假体周围骨折（22／327，6．7％）、假体不稳定（17／327，5．2％）、假体柄断裂（5／327，1．5％）、髋臼内衬脱落（5／327，1．5％）。结论假体无菌性松动和感染是初次髋关节置换失败的主要机制，手术适应证和假体选择不当以及外科理念及技术局限是造成失败的关键因素。Objective To summarize the detailed failure mechanisms of revision hip arthroplasties and related risk factors. Methods From November 1988 to July 2008 revision of total hip artbroplasties was performed in 327 patients. The medical history, clinical and imaging material and operation records were investigated. Results Regarding revision as the end point of the study, the reasons for 327 revision arthroplasties were aseptic loosening in 226 hips （69. 1% ）, infection in 52 hips （ 15.9% ） , periprosthetic fracture in22 hips （6.7%）, instability in 17 hips （5.2%）, stem fracture in 5 hips （1.5%） and liner dissociation in 5 hips （ 1.5% ）. Conclusions The main failure mechanisms of primary hip arthroplasties are aseptic loosening and infection of implants, which could be attributed to improper selection of operation indications and implants and limitations to surgical philosophy and technique.

关 键 词：关节成形术 置换 髋 治疗失败 危险因素 

分 类 号：R686[医药卫生—骨科学]