大头径全金属髋关节假体的临床应用及疗效分析  

CLINICAL APPLICATION AND EFFICENCY ANALYSIS OF TOTAL HIP ARTHROPLASTY WITH METAL-ON-METAL PROTHESIS

作　　者：葛建华[1] 鲁晓波[1] 张忠杰[1] 陈歌[1] 卓乃强[1] 

机构地区：[1]泸州医学院附属医院骨与关节外科,泸州646000

出　　处：《现代预防医学》2010年第5期962-965,共4页Modern Preventive Medicine

摘　　要：[目的]分析大头径金属对金属髋关节假体治疗髋关节炎性疾病、股骨头坏死等的应用及临床疗效。[方法]113例(121肢)中行大头径金属对金属假体置换58肢,金属对聚乙烯假体置换63肢,均取改良Gibson入路,对手术时间、术中出血、下床时间、并发症、Harris评分等进行比较分析。[结果]术后均随访时间2.5～4.5年,平均3.6年,所有患者均顺利通过手术,术后X线示所有置换假体植入位置满意,没有假体松动、移位现象出现。金属对金属较金属对聚乙烯全髋置换术后下床时间早(P﹤0.05),Harris评分:金属对金属全髋置换为(94.4±10.5)分,优良率93.1%,金属对聚乙烯全髋置换为(89.4±8.4)分,优良率87.3%。[结论]选择大头径金属对金属全髋关节置换治疗髋关节炎性疾病、股骨头坏死等,在关节稳定性、关节功能等方面获得满意疗效。[Objective] To analyze the clinical application and effect of total hip arthroplasty with metal-on-metal prothesis to treat hip osteoarthritis diseases,femoral head necrosis,and so on.[Methods] 113 patients with 121 diseased limbs were analysed.58 cases of total hip arthroplasty were selected with metal-on-metal prothesis,and 63 cases of total hip arthroplasty were selected with metal-on-polythen prothesis.All operations selected reforming Gibson＇s approach.The operation time,bleeding,complication and Harris score were analyzed after operation.[Results] All were followed up for 2.5 to 4.5 years（average 3.5 years）.All patients had been successfully accomplished operation,all replacement prostheses were without loosening or displacing,and their fixed locations were good.The patients of metal-on-metal total hip arthroplasty ambulated earlier than the patients of metal-on-polythen（P﹤0.05）.According to the Harris evaluation：the score of metal-on-metal total hip arthroplasty was 94.4±10.5,and the rate of excellence and goodness was 93.1%,score of metal-on-polythen total hip arthro-plasty was 89.4±8.4,and the rate of excellence and goodness was 87.3%.[Conclusion] The clinical application gains good effect on metal-on-metal total hip arthroplasty in treatment of hip osteoarthritis disease,femoral head necrosis,and so on.

关 键 词：金属对金属 金属对聚乙烯 全髋关节置换 

分 类 号：R684[医药卫生—骨科学]