全髋关节置换术后翻修的原因分析  

Analysis of the reasons for revision total hip arthroplasty

作　　者：杨飞 王国栋[1] 马辉 赵晓伟[1] YANG Fei;WANG Guo-dong;MA Hui;ZHAO Xiao-wei(Department of Orthopaedics,the Affiliated Hospital of Jining Medical University,Jining,Shandong 272067,China)

机构地区：[1]济宁医学院附属医院骨关节科,山东济宁272067

出　　处：《中国骨与关节损伤杂志》2020年第6期561-564,共4页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金(81871814)。

摘　　要：目的分析全髋关节置换术后行翻修手术的具体原因,并与以往文献报道的结果进行比较。方法回顾性分析自2014-01—2019-06完成的93例全髋关节翻修术,翻修术前均为初次单侧全髋关节置换术。将患者分为早期组(假体使用时间<5年)和晚期组(假体使用时间≥5年),统计行翻修手术的原因,并对数据进行描述性分析。结果45例(48.4%)全髋关节翻修原因为假体无菌性松动,19例(20.4%)为假体周围感染,15例(16.1%)为假体周围骨折,8例(8.6%)为聚乙烯内衬磨损,4例(4.3%)为髋关节反复脱位,髋关节疼痛、骨水泥游离体各1例。93例假体使用时间为(7.72±6.39)年,早期组38例,假体使用时间为(1.50±1.50)年;晚期组55例,假体使用时间为(12.02±5.09)年。早期组中13例假体周围感染,10例假体无菌性松动,9例假体周围骨折,4例髋关节反复脱位,1例聚乙烯内衬磨损,1例骨水泥游离。晚期组中35例假体无菌性松动,7例聚乙烯内衬磨损,6例假体周围感染,6例假体周围骨折,1例髋关节疼痛。结论假体无菌性松动是全髋关节置换术后最常见的翻修原因,随后依次为假体周围感染、假体周围骨折、聚乙烯内衬磨损、髋关节脱位等,这与国内外许多学者的研究一致。Objective To explore the reasons of revision total hip arthroplasty and compare with previous studies.Methods A retrospective analysis of 93 patients who underwent revision total hip arthroplasty from January 2014 to June 2019 was performed.All patients underwent the primary total hip arthroplasty before revision.The patients were divided into early group(within 5 years)and late group(more than 5 years).This study aimed to investigate the reasons for the revision surgery and the data were analyzed descriptively.Results The main reason of revision was aseptic loosening in 45 patients(48.4%),followed by infection in 19 patients(20.4%),periprosthetic fractures in 15 patients(16.1%),and polyethylene wear in 8 patients(8.6%),dislocation caused by unstable joints in 4 cases(4.3%),finally,pain and bone cement free body in 1 case each,respectively.The mean prosthetic survival time was(7.72±6.39)years in 93 cases,the time was(1.50±1.50)years in the 38 cases early group,and the time was(12.02±5.09)years in the 38 cases late group.In the early group,there were infection in 13 cases,10 cases of aseptic loosening,9 cases of periprosthetic fracture,4 cases of dislocation caused by unstable joints,1 case of polyethylene wear,and 1 case of bone cement free body.In the late group,there were aseptic loosening in 35 cases,7 cases of polyethylene wear,6 cases of infection,6 cases of periprosthetic fractures,and 1 case of hip pain.Conclusion The main reason of revision total hip arthroplasty is aseptic loosening,followed by infection,periprosthetic fractures,polyethylene wear,dislocation caused by unstable joints,which is consistent with most previous studies at home and abroad.

关 键 词：全髋关节置换术 全髋关节翻修术 假体无菌性松动 假体周围骨折 假体周围感染 

分 类 号：R687.42[医药卫生—骨科学]