生物型初次全髋关节置换术的中期随访结果  

Midterm results of cementless primary total hip arthroplasty

作　　者：何平[1] 龚翰[1] 陈东峰[2] 卢伟杰[2] 

机构地区：[1]广东省河源市紫金县人民医院骨科,517400 [2]广州医科大学附属第一医院骨科,510120

出　　处：《中华关节外科杂志（电子版）》2016年第3期33-36,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨生物型固定的全髋关节置换术中髋臼假体的中期临床疗效。方法回顾性分析紫金县人民医院骨科与广州医科大学附属第一医院骨科自2002年1月至2010年9月收治的194例（206髋）生物型全髋关节置换术病例,排除合并髋关节感染、恶性肿瘤、患肢神经肌肉疾病者,随访时间5~13年,平均8.9年,临床观察髋关节功能评分（Harris评分）、并发症、影像学检查评估假体稳定性,组间比较采用配对样本t检验,计量资料对比采用卡方检验,假体生存率采用Kaplan-Meier方法进行分析,以无菌性松动导致的假体翻修作为随访终点。结果共116例（126髋）获得完整随访。Harris评分由术前的（50.3±13.2）分提高至末次随访时的（96.4±5.1）分,差异有统计学意义（t=3.124,P〈0.001）。其中术后并发症包括无菌性松动（7例7髋）、脱位（3例3髋）、深静脉血栓（1例1髋）、异位骨化（11例11髋）,手术部位浅表感染（3例3髋）。以无菌性松动导致的假体翻修作为随访终点,髋臼假体13年累计生存率为88%,股骨假体13年累计生存率为100%。结论全髋关节置换术生物型髋关节假体的中期生存率满意,并发症少,临床结果好。Objective To evaluate the clinical and radiographic results of cementless primary total hip arthroplasty（ THA） by a midterm follow-up. Methods A series of 194 patients（ 206 hips） who had undergone cementless primary THA from January 2002 to September 2010 were involved in this retrospective study. Those patients with history of hip infection,malignant tumor or neuromuscular diseases were excluded. The mean follow-up time was 8. 9 years（ range,5-13 years）. Clinical outcomes were evaluated based on the Harris score. Complications were recorded and components loosening was assessed in the anterior posterior and lateral X-ray examinations of the hips. Paired T test and Chi square test were used. Kaplan-Meier method was used to evaluate the survivorship of prothesis. Results A total of 126 hips in 116 patients were available. The average Harris score improved from preoperative（ 50. 3 ± 13. 2） to（ 96. 4 ±5. 1） at the last follow-up（ t = 3. 124,P〈0. 001）. The postoperative complications included aseptic loosening（ seven hips）,dislocation（ three hips）,deep vein thrombosis（ one hip）,and ectopic ossification（ 11 hips）. The survivorship of femoral components was 100% as revision caused by aseptic loosening was set for the endpoint,while that of the acetabular components was 88%. Conclusion Primary total hip arthroplasty with cementless prothesis in this group shows a satisfactory clinical and radiographic outcomes in the midterm follow-up.

关 键 词：髋 关节形成术 存活率 

分 类 号：R687.4[医药卫生—骨科学]