股骨侧远端生物固定假体在高龄患者全髋关节翻修中的应用  

Clinical application of un-cemented distal femoral prosthesis in elderly patients undergoing total hip revision

作　　者：蒋林[1] 李舰[1] 简小飞[1] 张施展[1] 

机构地区：[1]武汉市中心医院骨外科,湖北省武汉市430014

出　　处：《中国组织工程研究与临床康复》2011年第43期8042-8045,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:对高龄患者行人工全髋关节翻修时如何正确选择股骨侧假体固定方式,可否应用组配式股骨假体处理此类难题?目的:验证股骨侧生物固定型假体在老年人全髋翻修后的效果。方法:采用远端固定生物型股骨假体对11例75岁以上股骨侧假体松动患者进行翻修。11例股骨骨缺损根据Paprosky分型,Ⅰ型2髋,Ⅱ型2髋,ⅢA型7髋。结果与结论:11例患者均随访16个月以上,患者Harris评分从翻修前的37分(22～49分)改善至随访结束时的89分(78～92分),优良率>90%,无患者发生再次松动。翻修后X射线片显示假体周围骨质密度和厚度明显增加。提示远端固定生物型假体可在股骨远端髓腔内获得可靠的轴向及抗旋转初始稳定性,尤其适用于伴有近端骨缺损的高龄患者的翻修治疗。BACKGROUND：It is still a thorny problem faced by orthopedic surgeons how to select the right femoral prosthesis fixation in total hip revision in elderly patients at present.Application of revision surgery with modular femoral prosthesis can effectively deal with such problems.OBJECTIVE：To evaluate the clinical outcomes of the application of un-cemented distal fixation stem in the total hip revision of elderly patients.METHODS：Eleven patients aged over 75 years with aseptic loosening femoral stem were revised.According to Paprosky classification system,type Ⅰ was 2 cases,type Ⅱ was 2 cases,type ⅢA was 7 cases.RESULTS AND CONCLUSION：All cases were followed up for over 16 months.The average Harris hip score increased from 37 to 89.The excellent or good rate post-surgery was above 90%.No loosening occurred again after revision.The radiographs after surgery showed increased bone density and thickness around the prosthesis.Reliable axial and anti-rotational stability can be achieved with the application of un-cemented distal fixation stem.It is especially appropriate for the revision surgery in elderly patients.

关 键 词：人工关节 翻修 股骨 骨缺损 高龄患者 

分 类 号：R318[医药卫生—生物医学工程]