生物型人工全髋关节置换治疗股骨头坏死  

Clinical study on cementless total hip replacement in treating later stage femoral head necrosis

作　　者：马业涛[1] 宋世锋[1] 肖海涛[1] 张熙民 曾凡[1] 陈世强[1] 刘福存[1] 姚理阳[1] 

机构地区：[1]海南省人民医院创伤骨科,海南海口570311

出　　处：《临床骨科杂志》2011年第4期381-383,共3页Journal of Clinical Orthopaedics

摘　　要：目的探讨生物型人工全髋关节置换治疗股骨头缺血性坏死早、中期疗效。方法采用生物型假体治疗23例股骨头坏死患者（27髋）。临床评估采用Harris评分标准;影像评估根据置换后随访双髋关节正、侧位X线片,观察臼杯、股骨假体位置及周围骨质改变,并测量臼杯内衬磨损速度与趋势。结果 23例均获随访,时间3~5年。Harris评分术前平均41.5分±2.3分,术后平均93.2分±3.5分。假体均位于解剖位置,无术后感染及松动发生,术前患者双下肢长度差为1~5 cm,术后为≤1 cm。21例25髋疼痛完全消失,患者步态正常;2例2髋有轻度疼痛伴有轻度跛行,生活自理且恢复正常工作。结论生物型假体用于治疗股骨头坏死晚期患者全髋关节置换术中,能够提供理想功能效果,早、中期疗效满意。Objective To study the effect of cementless total hip replacement in treating later stage femoral head necrosis.Methods 23 cases of femoral head necrosis（27 hips） were undergone cementless total hip replacement.The clinical assessment of the standards were based on Harris score and image assessment on upright and lateral X-rays of both hips before and after operation,the position of acetabular cup and femoral prosthesis,the changing of surrounding bone,and the abrasion velocity and tendency of inner linings of acetabular cup.Results All the 23 cases gained a follow-up of 3 to 5 years.Harris score improved from 41.5±2.3 points before operation to 93.2±3.5 points postoperatively.The implants were all located in the anatomical position without infection and loosening.The preoperative leg length difference was 1 to 5 cm while 0 to 1 cm postoperatively.21 cases（25 hips） achieved complete pain remission and regained normal gait,while 2 patients（2 hips） resulted in mild pain with slight limp,but could return to normal daily living and work.Conclusions Cementless prosthesis in treating femoral head necrosis of later stage can provide ideal effects.The early and midterm clinical results are satisfactory.

关 键 词：全髋关节置换 生物型假体 股骨头坏死 关节功能 

分 类 号：R681.8[医药卫生—骨科学] R687.4[医药卫生—外科学]