全陶瓷型人工髓关节置换治疗股骨头缺血性坏死23例

目的:全髋关节置换存在的主要问题是假体无菌性松动,为此许多不同特质的关节假体界面被研究利用,陶瓷对陶瓷型假体就是其中的一种.观察陶瓷一陶瓷人工髋关节置换治疗股骨头缺血性坏死的中短期疗效,并评估其临床应用价值.方法:于2006-01/2008-12对23例(28髋)采用陶瓷一陶瓷非骨水泥型假体置换治疗的股骨头缺血性坏死患者进行随访,所有关节假体均使用BiCONTACT.全陶瓷关节假体.应用Harris评分标准进行功能评价,应用股骨Gruen与髋臼Delee-Charnly分区方法进行影像学评价.结果:平均随访28个月.患者Harris评分从置换前平均39.45分提高至置换后平均88.57分,差异具有显著性意义(P＜0.05).影像学上无明显的假体松动、下沉.结论:对于股骨头缺血性坏死患者,新型陶瓷一陶瓷假体短期随访置换效果良好,影像学表现无明显松动.

Ceramic-on-ceramic total hip arthroplasty for treating avascular necrosis of the femoral head in 23 cases

OBJECTIVE: Aseptic prosthetic loosening is a primary problem of total hip arthroplasty. For this reason, several prosthesis interfaces with different characteristics have been studied, such as ceramic-on-ceramic prosthesis. The purpose of this study wasto investigate the mid- and short-term curative effects of ceramic-on-ceramic total hip arthroplasty in treatment of avascularnecrosis of the femoral head (ANFH) and to evaluate its clinical application value.METHODS: A total of 23 patients (28 hips) with ANFH who received ceramic-on-ceramic non-cement hip prosthesis replacementwere followed up. All hip prostheses were BiCONTACT~((R)) ceramic-on-ceramic hip prostheses. Functional evaluation was assessedaccording to the Harris hip score. Radiographic analysis was performed using the Gruen's zonal method for the stem and the zonal classification of Delee-Charnley for the cup implants.RESULTS: All patients were followed up for an average of 28 months. The mean Harris hip scores ranged from 39.45 points prior to surgery to 88.57 points after surgery, with a difference which was significant (P < 0.05). Radiographically, no obvious prosthesis loosening or subsidence was observed. CONCLUSION: The ceramic-on-ceramic total hip arthroplasty can produce good short-term curative effects in treatment of ANFH.Radiographic findings do not show obvious prosthesis loosening.