Zweymüller非骨水泥型全髋关节初次置换术后8～10年病例随访  

Follow-up of 8 to 10 years after Zweymüller uncemented total hip total replacement

作　　者：常青[1] 孙凯[1] 刘瑞[1] 赵建民[1] Chang Qing;Sun Kai;Liu Rui(Department of Orthopedics,Affiliated Hospital of Inner Mongolia Medical University,Hohhot Inner Mongolia,010050,China)

机构地区：[1]内蒙古医科大学附属医院骨科,内蒙古呼和浩特010050

出　　处：《生物骨科材料与临床研究》2019年第2期15-20,共6页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的评估Zweymüller非骨水泥型假体在人工全髋关节初次置换术后的中期随访疗效,并对随访过程中的相关问题加以总结。方法根据病例纳入标准对我院骨科2006年1月至2009年1月行Zweymüller非骨水泥型全髋关节初次置换术的100例患者(108髋)进行随访,随访以门诊随访为主、电话随访和家庭随访相结合的方式。至末次随访时,59例患者(64髋)获得随访并取得完整随访资料,平均随访时间9.2年(8～10年)。对完整的随访资料进行临床和影像学评估,临床评估内容包括术前、术后Harris评分及术后相关并发症的记录;影像学评估包括观察分析末次随访复查的和术后1周内复查的患者骨盆正位片(比较双侧髋),患髋关节正侧位片,根据影像学评估结果评判假体位置情况,分析假体周围是否存在透亮带、是否发生骨溶解,假体是否发生无菌性松动,股骨近端应力遮挡情况以及异位骨化等情况。结果最终随访率为59%,Harris评分由术前的平均(46.30±10.06)分(17～61分)提高至最后一次随访时的平均(91.20±5.14)分(75～100分),优良率为87.5%。术后相关并发症发生率23.7%,包括髋部疼痛(1例1髋)、假体脱位(1例1髋)、深静脉血栓(1例1髋)、跛行(5例)、术后肢体不等长10 mm以上(6例);股骨柄假体和螺旋臼杯假体存留率均为100%;透亮带发生率12.5%,均为区域性透亮带;骨溶解发生率4.7%;股骨近端应力遮挡发生率61%;异位骨化发生率17.2%。结论通过对本组8～10年术后病例的随访,Zweymüller非骨水泥型全髋关节初次置换术的中期随访结果总体疗效令人满意。Objective To evaluate the efficacy of the Zweymuller uncemented prosthesis in the mid-term follow-up after primary hip replacement, and to summarize the related problems during the follow-up process. Methods A total of 100 patients (108 hips) who underwent Zweymuller uncemented total hip arthroplasty from January 2006 to January 2009 were enrolled according to the inclusion criteria. The follow-up was based on outpatient visits, combining telephone follow- up and home follow-up. At the last follow-up, 59 patients (64 hips) were followed up and completed follow-up data, with an average follow-up of 9.2 years (8 to 10 years). Clinical and imaging evaluations were performed on complete follow-up data. The clinical evaluation included preoperative and postoperative Harris scores and postoperative complications. The imaging evaluation included observation and analysis of the patients who underwent the last followup review and those who were reviewed within 1 week after surgery, and the pelvic anterior segment (compared to the bilateral hips), and the positive lateral radiograph of the hip joint, according to imaging evaluation results to assess the position of the prosthesis, analysis of the existence of translucent bands around the prosthesis, whether osteolysis occurs, whether the prosthesis is aseptic loosening, stress shielding of the proximal femur and ectopic ossification. Results The final follow-up rate was 59%. The Harris score increased from an average of46.30±10.06 points (17-61 points) before surgery to an average of 91.20士5.14 points (75-100 points) at the last follow-up. The excellent and good rate was 87.5%. Postoperative complications. The incidence rate was 23.7%, including hip pain (lh ip ), prosthesis dislocation (1 hip), deep vein thrombosis (1 hip ), claudication (5 cases), and limb length unequal 10 mm above (6 cases);the retention rate of femoral stem and spiral cup prosthesis were 100%;the incidence of translucent band was 12.5%, all of which were regional translucent bands;the incidence of

关 键 词：髋 关节成形术 初次置换 随访 

分 类 号：R687.42[医药卫生—骨科学]