Tri-Lock骨保留型股骨柄在初次全髋关节置换术中应用的短期疗效观察  

Short-term outcome of Tri-Lock bone preservation stem in primary total hip arthroplasty

作　　者：赵金海[1] 康鹏德[1] 杨静[1] 沈彬[1] 周宗科[1] 裴福兴[1] 谢小伟[1] 李东海[1] 杨周源 

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国矫形外科杂志》2017年第11期983-988,共6页Orthopedic Journal of China

摘　　要：[目的]评价Tri-Lock骨保留型股骨柄(Tri-Lock BPS)应用于初次全髋关节置换术的短期疗效。[方法]回顾性分析2013年3月~2014年1月四川大学华西医院骨科关节外科使用Tri-Lock BPS假体进行初次全髋关节置换术治疗髋关节疾患210例(228髋),对比手术前后Harris髋关节评分、生命质量SF-12量表评分,分析影像学结果,记录与股骨内置物相关的并发症。[结果]至末次随访时,188例203髋(89.04%)获得随访,平均随访时间(29.50±5.98)个月(24~36个月),Harris评分由术前平均(38.60±6.12)分提高至末次随访时的(98.07±2.88)分,差异具有统计学意义(P<0.001);其中197髋(97.04%)优,6髋(2.96%)良,优良率100%;患者术前生命质量SF-12量表PCS:(28.44±4.38)分,MCS:(53.25±5.11)分,末次随访时PCS:(52.93±2.42)分,MCS:(60.47±1.72)分,差异具有统计学意义,(P<0.001);203髋股骨假体影像学资料均评定为稳定骨长入,未发现股骨柄周围透亮线、假体周围骨溶解或假体松动及假体柄下沉超过3 mm病例,无死亡及翻修病例,1例1髋(0.50%)术中安放股骨假体时发生股骨距劈裂,5例5髋(2.46%)出现小腿肌间静脉血栓,4例4髋(2.00%)出现偶发性股区痛。[结论]Tri-Lock BPS假体初始稳定性佳,早期骨长入良好,短期应用疗效满意,长期效果有待于进一步随访观察。[Objective] To investigate the short term results of Tri-Lock bone preservation stem （Tri-Loek BPS, DePuy, Warsaw, IN） in primary total hip arthroplasty. [Methods] A total of 210 patients （228 hips） received total hip arthroplasty with Tri-Lock BPS. The Harris score, SF-12 scoring system and radiological images were recorded and compared pre- and postoperatively. Complications related to the implantation were observed. [Results] After surgery, 203 hips （89.04%） were available for the minimum of 24 months follow-up with a mean of （29.5±5.98） months （range, 24-36 months） . The mean Harris hip score significantly improved from （38.60＋6.12） preoperatively to （98.07±2.88） at the latest follow-up （P〈0.001） . Additionally, the mean SF-12 score physical component summary （PCS） and mental component summary （MCS） scores noteworthily improved from （28.44±4.38） and （53.25±5.11） to （52.93±2.42） and （60.47± 1.72） respectively （P〈0.001） . All of the femoral components were clinically stable with radiographic evidence of bone in-growth. In term of complications, femoral calcar fracture occurred in 1 hip （0.50%） as the prosthesis was been im- planting, moreover, intramuscular veins thrombosis in 5 hips （2.46%） and transitory thigh pain in 4 （2.00%） were found. No subsidence of the prosthesis more than 3 mm was noted in any patient and no femoral revisions was needed for any reason. [Conclusion] Total hip arthroplasty with the Tri-Lock BPS has good clinical and radiographic results at short-term follow-up.

关 键 词：非骨水泥型 初次全髋关节置换 近端多孔涂层 骨保留型股骨柄 

分 类 号：R687.4[医药卫生—骨科学]