非组配锥形带脊钛柄应用于人工髋关节翻修术中股骨侧重建的中期随访研究  

Mid-term follow-up of non-modular tapered fluted titanium stems in revision total hip arthroplasty

作　　者：褚亚明[1] 黄勇[1] 周一新[1] 张金庆[1] Chu Yaming;Huang Yong;Zhou Yixin;Zhang Jinqing(Department of Orthopedics,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院矫形骨科,北京100035

出　　处：《中国医刊》2020年第12期1327-1331,共5页Chinese Journal of Medicine

摘　　要：目的探讨非组配锥形带脊钛柄应用于人工髋关节翻修术中股骨侧重建的中期临床疗效。方法回顾性分析2008年4月至2011年9月在北京积水潭医院人工髋关节翻修术中采用非组配锥形带脊钛柄行股骨侧骨缺损重建的62例患者的临床资料,包括一般资料(性别、年龄、身高、体重、术前诊断、术前Harris髋关节评分)、临床疗效(术后Harris髋关节评分、主观满意度)、生存率、影像学结果及并发症发生情况(术中骨折、假体周围感染、术后脱位、术后假体周围骨折、再次翻修)等。结果本组患者术后随访5.12~8.09年,平均(6.43±0.85)年;术后Harris髋关节评分为(86.05±11.01)分,明显高于术前的(43.98±13.27)分,差异有显著性(P<0.01)。所有假体的远端部分均获得了稳定的骨长入。术后股骨柄下沉(2.11±4.57)mm,下沉大于5mm者有5例(8.1%)例,最大下沉量为28mm;下沉的股骨柄均获得了二次稳定。本组患者术中出现骨皮质穿孔2例(3.2%),术中骨折2例(3.2%)例;术后发生假体周围骨折1例(1.6%),大粗隆骨折不愈合并移位1例(1.6%),假体周围感染2例(3.2%),未发生术后脱位、无菌性松动、假体断裂等。结论人工髋关节翻修术中采用非组配锥形带脊钛柄可获得优良的中期随访结果。Objective To investigate the clinical outcomes,radiographic results and frequency of complications of non-modular tapered fluted titanium stems in revision THA at mid-term follow-up.Method A retrospective review of 76 consecutive THAs revised with a tapered fluted non-modular titanium stem between April 2008 and September 2011 was conducted.The inpatient and outpatient records were examined for complications including infection,intraoperative fracture,dislocation,postoperative periprosthetic fracture,mechanical failure associated with the modular junction and subsequent reoperation.Attending surgeons and their full-time assistants evaluated the patient’s outcome(Harris Hip Score,pain,subjective satisfaction).The patient’s clinical outcome,complications and radiographic results were examined.Result The study revealed that mean duration of follow-up was 5.12-8.09 years(average 6.43±0.85 years).The Harris hip score improve from(43.98±13.27)preoperatively to(86.05±11.01)at the latest follow-up(P<0.001).All the stem obtained boneingrowth fixation.The average subsidence of the stem was(2.11±4.57)mm and 5(8.06%)stems subsided more the 5 mm with a largest subsidence of 28 mm.The complications included 2 intraoperative fracture in 2 patients,intraoperative femoral perforation in 2 patients,postoperative femoral fracture in 1 patient,great trochanter fracture and non-union in 1 patient and periprosthetic fracture in 1 patient.No postoperative dislocation,aseptic loosening or stem fracture occurred.Conclusion Non-modular tapered fluted titanium stems provide satisfactory mid-term results in revision THA.

关 键 词：人工髋关节翻修术 非组配锥形带脊钛柄 临床结果 并发症 影像学结果 

分 类 号：R687.4[医药卫生—骨科学]