Wagner SL 翻修型股骨柄在人工髋关节翻修术中的疗效分析简

目的探讨采用WagnerSL翻修型股骨柄在人工髋关节翻修中的方法及疗效。方法自2006年3月至2012年3月，采用Wagner自锁式无骨水泥固定型翻修股骨柄对31例患者（共31髋）行人工髋关节翻修术。其中男性16例，女性15例；年龄41～75岁，平均63．2岁。髋关节翻修术距离初次人工全髋置换的时间是1—20年，平均65．3个月。翻修原因：无菌性假体松动25例，髋关节假体周围感染6例，均为第一次翻修。结果31例均获得了随访，随访时间为0．5—6年，平均为2．7年。患者手术后切口均为I期愈合，无下肢深静脉血栓及坐骨神经损伤等并发症出现。在随访期间没有出现假体松动和感染，假体周围可以看到明显骨长入。有9例患者出现了不同程度的假体下沉，但均无明显的髋部疼痛症状，因此未做特殊处理。末次随访时，Harris评分由（36．24±8．27）分提高到（83．78±4．92）分，MedeD’Aubigne评分由（2．54士5．38）提高到（13．42士3．26）分，VAS疼痛评分由（7．32士0．72）分减低到（1．26±0．61）分，与手术前比较差异具有统计学意义（P〈0．05）。结论使用WagnerS“L”型翻修股骨柄进行人工髋关节翻修术后，近期疗效满意，能明显地缓解疼痛，改善了髋关节的功能。

Clinical Application of Wagner SL Fomoral Revision Stem in Hip Prosthesis Revision Summary

Objective To discuss the therapeutic effect of distal fixed Wagner SL Revision Hip Stem for the prosthesis re- vision. Methods From March 2006 to March 2012, Wagner SL Revision Hip Stem was used for the hip prosthesis revision in 31 patients （31 hips）. There were 16 males and 15 females （average age,63.2 years old,range,41 to 75 years old）. The time from revision to total hip arthroplasty was 1 to 20 years （ average,65.3 months）. The causes of revision included aseptic loose- ning in 25 cases, and deep infection in 6 cases. First revision was performed in 31 cases. Preoperative Harris score was （36.24 ~ 8.27 ）. Merle D＇ Aubigne score was （2.54 ± 5.38）. VAS score was （7.32 ± 0.72 ）. Results All patients achieved healing of incision by first intention without deep venous thrombosis and nerve injury. Thirty-one cases were followed up 0.5 to 6 years, with an average of 2.7 years. No prosthetic loosening or infection occurred. Bone ingrowth was observed around the im- plant during the follow-up period. At last follow,up,2 cases had femoral stem subsidence without obvious hip pain and other symptoms, and no special treatment was given. Harris score was （83.78 ± 4.92）, Merle D＇ Aubigne score was （ 13.42 ± 3.26） and VAS score was（ 1.26 ± 0.61 ）, at last foUow-up , showing significant differences when compared with it before operation （ P 〈 0.05）. Conclusion The short-term result of Wagner SL revision hip stem in hip prosthesis revision is satisfactory, and it can improve hip function and relieve the pain obviously.