人工髋关节翻修手术85例临床分析  

Clinical analysis of revision of total hip arthroplasty in 85 cases

作　　者：程旭光[1] 刘珂[2,3] 唐超[2,3] 张瑜哲[2,3] 杨彬[2,3] 李寒曦[1] 张俊峰[1] 郑稼[2,3] 

机构地区：[1]新乡医学院,2012级河南新乡453000 [2]郑州大学人民医院 [3]河南省人民医院骨科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2015年第5期494-495,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技攻关项目(142102310081)

摘　　要：目的探讨人工髋关节翻修术的原因及疗效。方法人工髋关节置换术后假体无菌性松动患者50例、术后感染15例、假体周围骨折15例、脱位5例,85例（85髋）均行人工髋关节翻修手术;比较手术前、后Harris评分及VAS评分,评价临床疗效。结果本组手术过程均顺利,术后患者关节疼痛症状均较术前改善,围手术期无严重并发症发生;随访10~60（39.93±2.57）个月,末次随访时患者VAS评分（1.32±0.17）较术前（6.92±0.23）明显降低,Harris评分（87.53±2.00）较术前（34.82±1.40）提高,差异有统计学意义（P〈0.05）;影像学检查示假体位置良好,髋臼侧植骨明显增厚,未见假体周围透亮线及骨溶解,治疗优良率90.59%。结论假体无菌性松动、假体周围骨折和感染是引起人工髋关节置换术后翻修的主要原因,髋关节翻修术短期疗效满意。Objective To analyze the cause and curative effect of revision of total hip arthmplasty.Methods A total of85 hips in 50 patients with aseptic looseness,15 patients with infection,15 patients with prosthesis adjacent fracture and5 patients with prosthesis dislocation after artificial hip replacement,underwent the revision of the total hip arthroplasty.Harris score and VAS score were compared before and after operation to evaluate the clinical effect.Results The surgeries were successfully performed and no serious complications occurred in perioperative period.The symptom of joint pain was relieved after operation.All patients were followed up for 10 to 60（39.93±2.57）months.The VAS score reduced from 6.92±0.23 before operation to 1.32±0.17 after operation,and Harris score raised from 34.82±1.40 before operation to 87.53±2.00 after operation,showing significant differences（P0.05）.X-ray results showed good location of prosthesis and acetabular bone graft thickening,with no periprosthetic osteolysis or radiolucent line.The excellent rate was 90.59%.Conclusion The main causes of revision after total hip replacement are aseptic looseness,and prosthesis adjacent fracture and infection after the primary operation.Revision of total hip arthroplasty can achieve satisfactory short-term effect.

关 键 词：人工髋关节 翻修术 近期疗效 

分 类 号：R687.4[医药卫生—骨科学]