采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究  

COMPARATIVE STUDY ON HIGH CROSS-LINKED AND TRADITIONAL POLYETHYLENE CUP LINERS IN TOTAL HIP ARTHROPLASTY

作　　者：魏召劝 孙俊英[1] 查国春[1] 董圣杰[1] 王涛[1] 方远[1] 

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中国修复重建外科杂志》2013年第12期1414-1418,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的比较采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换（total hip arthroplasty，THA）术后髋臼内衬线性磨损程度及疗效。方法回顾分析2005年1月-2007年3月61例（64髋）行初次THA患者的临床资料，其中30例（31髋）采用高交联聚乙烯髋臼内衬（试验组），31例（33髋）采用传统聚乙烯髋臼内衬（对照组）。两组患者性别、年龄、体重、病因及术前Harris评分比较，差异均无统计学意义（尸〉0．05）。记录术后并发症发生情况，采用Harris评分评定髋关节功能。摄x线片观察假体周围骨溶解及假体松动情况，测量股骨头累积穿透位移值及线性磨损率。结果术后患者切口均I期愈合，无早期并发症发生。两组患者均获随访，试验组随访时间为5～7年，平均6．3年；对照组为4～7年，平均6．5年。两组术后3个月及末次随访时Harris评分比较，差异均无统计学意义（P〉0．05）。对照组3例（3髋）发生骨溶解，试验组无骨溶解发生；两组均未出现假体松动。术后1～7年试验组股骨头累积穿透位移值均低于对照组，差异有统计学意义（P〈0．05）。试验组线性磨损率为（0．025±0．002）mm／年，显著低于对照组的（0．086±0．005）mm／年（Z=6．804，P=O．000）。结论采用高交联聚乙烯髋臼内衬行THA的疗效与传统聚乙烯髋臼内衬相似，但具有更好的抗磨损性能。Objective To compare the effectiveness and linear wear rates between high cross-linked polyethylene cup liner and traditional polyethylene cup liner. Methods A retrospective analysis was made on the clinical data of 61 patients （64 hips） who underwent primary total hip arthroplasty （THA） between January 2005 and March 2007. According to the type of cup liner, 61 patients （64 hips） were divided into 2 groups： high cross-linked polyethylene cup liner was used in 30 cases （31 hi ps, trial group）, and traditional polyethylene cup 1 iner in 31 cases （33 hi ps, control group）. There was no significant difference in gender, age, body weight, etiological factor, and preoperative Harris score between 2 groups （P 〉 0.05）. Complication was observed after operation; Harris score was used to assess hip function; X-ray film analysis was done to observe osteolysis and prosthesis loosening, and to measure cumulative penetration of the femoral head and linear wear rate. Results All incisions healed by first intention without complication. All patients were followed up. The mean follow-up was 6.3 years （range, 5-7 years） in trial group, and was 6.5 years （range, 4-7 years） in control group. There was no significant difference in Harris score between 2 groups at the 3 months after operation and last follow-up （P 〉 0.05）. Osteolysis was observed in 3 cases （3 hips） of control group, but no osteolysis in trial group. X-ray films showed no aseptic loosening in the patients of 2 groups. The mean cumulative penetration of trial group were significantly lower than those of control group at 1-7 years after operation （P 〈 0.05）. Linear wear rate of trial group [（0.025±0.002） mm/year] was significantly lower than that of control group [（0.086±0.005 ） mm/year] （Z=6.804, P=0.000）. Conclusion High cross-linked polyethylene cup liner has the similar effectiveness as traditional polyethylene cup liner, but it has lower linear wear rate than the traditional polyethylene cup liner.

关 键 词：人工全髋关节置换 髋臼内衬 高交联聚乙烯 骨溶解 

分 类 号：R687.4[医药卫生—骨科学]