全髋关节置换术髋臼杯螺钉固定与镶嵌固定的疗效分析  

Analysis on curative effects of screws and inlay fixations for acetabular cup in total hip arthroplasty

作　　者：姚楚亮[1] 陈少文[1] 杨焱鑫[1] 王华仁[1] 曾辉[1] 陈杰[1] 廖臻[1] 杨炎彬 

机构地区：[1]武警广东省总队医院外六科,广州510107

出　　处：《中华关节外科杂志（电子版）》2015年第4期26-29,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的对比分析生物型金属-聚乙稀人工全髋关节置换术中髋臼杯螺钉固定与镶嵌固定在髋关节疾病患者中的疗效。方法选取120例本组收治的需行生物型金属-聚乙稀人工全髋关节置换术的髋关节疾病患者,随机分为实验组(60例)和对照组(60例),分别经髋关节前外侧切口入路,实验组安装人工髋臼杯时直接打压镶嵌固定,而对照组安装人工髋臼杯时打压后再钻孔拧入2至3枚螺钉固定。详细记录患者术后5年随访时人工关节稳定的情况,并通过对髋关节功能评分作比较。结果实验组和对照组的患者术后人工髋关节恢复情况良好,人工髋关节中期稳定性良好,Harris评分均无统计学意义(P>0.05)。但实验组患者的手术时间较短,且术中出血量、术后引流量少于对照组患者,差异有统计学意义(P<0.05)。结论进行生物型金属-聚乙稀人工髋关节置换进行安装人工髋臼杯时,直接打压镶嵌固定和普通打压后再钻孔拧入2至3枚螺钉对比,术后髋关节恢复情况均良好,中期稳定性良好,固定牢固;但直接打压镶嵌固定术式手术时间缩短、术中出血及术后引流量较少,是临床上值得推广的手术方式。Objective To compare and analyze the curative effect of screws fixation and inlay fixation for acetabular cup in cementless metal-on-polyethylene total hip replacement. Methods A series of 120 cases with hip disease admitted in our department undergoing cementless metal-on-polyethylene total hip replacement were randomly divided into the experimental group（ 60 cases） and the control group（ 60cases）. The acetabular cup was fixed by inlay fixation in the experimental group,while it was installed by drilling and screws after impaction in the control group. The stability of artificial joints in the following five years was observed. The curative effect was assesed by Harris score. Results Both of the experimental group and the control group showed good recovery of the hip. The difference in Harris score between the two groups were not statistically significant（ P〈0. 05）. But the experimental group showed shorter operation time,less blood loss, and less postoperative drainage than the control group. The difference was statistically significant（ P〈0. 05）. Conclusion In cementless metal-on-polyethylene hip arthroplasty,the acetabular cup installation by direct inlay fixation with impaction has the similar effect to the traditional impaction and screw fixation,which presents shorter operation time,less blood loss and less postoperative drainage,and is worthy of popularization in clinic.

关 键 词：关节成形术 置换 髋 外科手术 

分 类 号：R687.4[医药卫生—骨科学]