两种假体术后关节遗忘度的比较研究  

Comparative Study on the Joint Amnesia of Two Total Hip Prosthesis

作　　者：张栋[1] 魏杰[2] 贾中伟[2] 孙久强[2] 刘建友 曹鑫杰 刘思稳 Zhang Dong;Wei Jie;Jia Zhongwei;Sun Jiuqiang;Liu Jianyou;Cao Xinjie;Liu Siwen(Shanxi Medical University,Taiyuan 030001,China;Department of Orthopedics,The Fifth Clinical Medical College of Shanxi Medical University,Taiyuan 030012,China)

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第五临床医学院,山西太原030012

出　　处：《实用骨科杂志》2022年第3期209-214,219,共7页Journal of Practical Orthopaedics

摘　　要：目的利用关节遗忘度评分来对比双动髋关节与固定内衬髋关节假体置换术后的近中期疗效。验证关节遗忘度评分是否较常见的术后评分量表有更好的天花板效应。方法选择在2017年1月至2020年12月在山西医科大学第五临床医学院骨科关节病区因股骨头坏死FilcatⅣ期进行的100例髋关节置换患者,其中男性41例,女性59例;年龄58~82岁,平均(62.74±11.96)岁。其中采用双动髋关节假体(DMC组)的51例,采用固定内衬全髋关节假体(CP组)的49例。术后1年及末次随访时进行Harris评分、西安大略和麦克马斯特大学(Western Ontario Mcmaster universities,WOMAC)骨关节炎指数、牛津髋关节评分(Oxford hip score,OHS)、患者满意度评分及关节遗忘度评分(forgotten joint score,FJS),所得数据进行统计分析。结果100例患者均获得2年以上的随访,随访期间未出现关节内脱位、假体松动、假体周围骨折及假体周围感染等并发症。术后1年及末次随访约2年的随访数据显示,两组间Harris评分、WOMAC评分、OHS评分及患者满意度评分比较差异无统计学意义(P>0.05),两组术后1年及末次随访的FJS评分比较差异有统计学意义(P<0.05)。采用双动髋关节假体的患者术后能获得更好的关节遗忘度。结论关节遗忘度在评价关节置换术后患者的功能及关节意识方面要更优于其他的评分量表;尽管两种假体置换术后患者在功能及疼痛方面有着相似的结果,但应用双动假体的患者术后关节感受更接近自然。Objective To compare the short-term and medium-term effects of double action hip joint and fixed lined hip prosthesis replacement by joint amnesia score.To verify whether the Forgotten Joint Score has a better ceiling effect than the common postoperative score scale.Methods 100 patients with hip arthroplasty due to femoral head necrosis of Filcat Ⅳ in the Joint Surgery Ward of the Fifth Clinical Medical College of Shanxi Medical University from January 2017 to December 2020 were selected, including 41 males and 59 females.The age ranged from 58 to 82 years, with an average age of(62.74±11.96)years, including 51 patients with dual-mobility cups hip prosthesis(DMC group) and 49 patients with fixed lined total hip prosthesis(CP group).Harris score, Western Ontario Mcmaster universities(WOMAC)osteoarthritis index, Oxford hip score(OHS),patient satisfaction score and forgotten joint score(FJS) were performed 1 year after operation and the last follow up(about 2 year).The data were statistically analyzed.Results 100 patients were followed up for more than 2 year.There were no complications such as intra-articular dislocation, prosthesis loosening, periprosthetic fracture and periprosthetic infection.The follow-up data at 1 year and 2 year after operation showed that there was no significant difference in Harris score, WOMAC score, OHS score and patient satisfaction score between the two groups(P>0.05).The FJS score at 1 year and 2 year after operation showed that there was significant difference between dual-mobility cups hip joint and fixed lined total hip joint(P<0.05).Patients with dual-mobility cups hip prosthesis could obtain better joint amnesia after operation.Conclusion The FJS is better than other scales in evaluating the function and joint consciousness of patients after joint replacement.Although the two prosthesis replacement patients have similar results in function and pain, the patients with dual-mobility cups hip prosthesis have a more natural joint feeling after operation.

关 键 词：全髋关节置换术 双动髋关节假体 关节遗忘评分:上限效应 

分 类 号：R687.42[医药卫生—骨科学]