保留股骨颈假体全髋关节置换:与传统设计假体置换效果的区别?  

Total hip arthroplasty with collum femoris preserving prosthesis:differences from traditional prosthesis

作　　者：黄和涛[1] 潘建科 谢辉[1] 杨伟毅 梁浩东 刘军 

机构地区：[1]广州中医药大学第二临床医学院,广东省广州市510405 [2]广州中医药大学第二附属医院(广东省中医院)关节骨科,广东省广州市510120

出　　处：《中国组织工程研究》2017年第31期5055-5060,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81473698);教育部高等学校博士点科研基金项目(20124425110004);国家中医药管理局中医药标准化项目(SATCM-2015-BZ115;SATCM-2015-BZ173);广东省科技计划项目(2012B061700037);广东省财政厅项目([2014]157号);广东省医学科学技术研究基金项目(A2017215);广东省中医药管理局项目(20164020);广东省中医院中医药科学技术研究专项(YK2013B2N19;YN2015MS15)~~

摘　　要：背景:传统全髋关节置换后,易导致发生假体松动、下沉等并发症,保留股骨颈假体独特的设计理念,有效的解决了上述问题。目的:综述和总结保留股骨颈假体的全髋关节置换的研究进展。方法:由第一作者用计算机全面检索中国生物医学文献数据库、中国知网、维普期刊数据库、万方资源数据库(1990年至2017年)和Pub Med,Embase,The Cochrane Library,Web of Science数据库(1990年至2017年),检索词分别为"保留股骨颈、全髋关节置换、"和"collum femoris preserving、CFP、total hip arthroplasty、TKA",语言分别设定为中文和英文。从保留股骨颈假体全髋关节置换的发展历史、设计理念、手术指征和禁忌证、并发症、手术注意事项和临床疗效等进行全方位的深入研究和总结。结果与结论:共纳入41篇文章。结果表明,保留股骨颈假体使股骨假体应力符合股骨近端生理状况分布,正常的偏心距得到较好的保留,有良好的抗旋转作用,进而有效避免因股骨近端骨质疏松继而造成的股骨假体松动、下沉,还能为远期翻修保留更多的骨储备。目前大多数研究仅可说明保留股骨颈假体具有一定的临床疗效,但是无法体现与传统设计的假体之间的区别。目前亟需进行相关的循证及临床研究,为临床保留股骨颈假体的使用提供较高质量的循证医学证据支持,进而为骨科医生的临床决策提供最佳外部证据。BACKGROUND： Traditional total hip arthroplasty can easily lead to the postoperative complications such as prostheticloosening and subsidence. The unique design concept of collum femoris preserving （CFP） prosthesis, effectively solvesthe above problems.OBJECTIVE： To summarize the research progress of CFP prosthesis in total hip arthroplasty.METHODS： A computer-based online retrieval in CNKI, CBM, VIP, WanFang, PubMed, Embase, The Cochrane Library,Web of Science databases from1990 to 2017 was performed with the keywords of “collum femoris preserving, CFP, totalhip arthroplasty, TKA” in English and Chinese, respectively. The development history of CFP, design concept, surgicalindications and contraindications, complications, surgical considerations as well as clinical effectiveness were analyzedand summarized.RESULTS AND CONCLUSION： A total of 41 articles were included. The stress distribution of CFU prosthesis is similarwith the physical condition of proximal femur. The preserved normal eccentricity has good resistance to rotation, thuseffectively avoiding prosthetic loosening and subsidence resulting from osteoporotic proximal femur, and still keeps morebone reserve for future revision surgery. Most of studies only prove that the CFP prosthesis has a certain curativeefficacy, but the differences between traditional and CFP prosthesis remain unclear. A large number of high-qualityevidence-based medicine and clinical researches are needed to support the clinical application of CFP prosthesis, thusproviding data reference for orthopedic surgeons.

关 键 词：骨科植入物 人工假体 保留股骨颈假体 全髋关节置换 研究进展 禁忌证 并发症 疗效 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]