金属对金属全髋置换术在36例50岁以下股骨头坏死患者中的疗效观察  

Therapeutic observation of metal on metal total hip arthroplasty in 36 cases of femoral head necrosis patients under 50-year-old

作　　者：杨士鹏[1] 金蕴[1] 李林[1] 

机构地区：[1]延边大学附属医院骨科,吉林延吉133000

出　　处：《延边大学医学学报》2012年第1期54-58,共5页Journal of Medical Science Yanbian University

摘　　要：[背景]比较金属对金属全髋置换术和金属对聚乙烯全髋置换术治疗50岁以下股骨头坏死的临床疗效.[病例报告]自2009年3月至2011年3月间采用金属对金属全髋置换术和金属对聚乙烯全髋置换术治疗50岁以下股骨头坏死患者,其中金属对金属组为36例(38髋),FicatⅢ期为11髋,FicatⅣ期为27髋;金属对聚乙烯组为30例(34髋),FicatⅢ期为9髋,FicatⅣ期为25髋.记录患者术后X线表现、髋关节运动范围、髋关节疼痛、有无扶拐等情况.对金属对金属组患者按照Harris评分标准进行评定,优良率为97%,金属对聚乙烯组优良率为90%,两组术后优良率间差异无统计学意义.两组假体治疗术后3d髋关节活动度比较间差异无统计学意义,术后24个月时髋关节活动度间差异具有统计学意义(P<0.05).[讨论]金属对金属全髋置换术具有疗效好、手术并发症少等优点,适合用于年轻的、对生活质量要求高的股骨头坏死患者.BACKGROUND To compare the clinical effects of metal total hip replacement（THR） and metal on polyethylene hip replacement（PHR） for treating the femoral head necrosis under 50-year-old.CASE REPORTS From March,2009 to 2011,patients with femoral head necrosis 50-year-old were operated by THR and PHR,in which metal on metal group had 36 cases（38 hips）,FicatⅢ period had 11 hips,FicatⅣ Period had 27 hips,and metal on polyethylene group had 30 cases（34 hips）,FicatⅢ period had 9 hips,FicatⅣ period had 25 hips.X-ray appearance,hip joint range of movement,pain of hip joint and whether holding crutches after operation were recorded in all patients.According to the Harris standard for evaluation,the excellent rate was 97%,90% in metal on metal and metal on polyethylene groups,respectively,and there were no statistical differences of excellent rate and hip joint range of movement at 3 days of post-operation between two groups,but there were significantly statistical difference in hip joint range of movement at 24 monthes of post-operation（P0.05）.DISCUSSION The metal on metal THR has better effects and fewer postoperative complications,and is suitable for patients with femoral head necrosis in younger and required high quality of life.

关 键 词：股骨头坏死 关节成形术 置换 髋 金属 

分 类 号：R687[医药卫生—骨科学]