258髋Corail股骨柄假体中期疗效观察

目的：探讨终末期髋关节疾病患者采用 Corail 羟基磷灰石(Hydroxyapatite,HA)全涂层股骨柄假体行全髋关节置换术(Total hip arthroplasty, THA)的中期疗效。方法：回顾性分析2011年 1 0月～2019 年 10月采用 Corail 假体行 THA 治疗 239例（258髋）髋关节终末期疾病患者的病例资料，其中男137例，女102例，年龄38~79岁，平均50.4岁。左髋117例，右髋141例。适应症包括股骨头缺血性坏死145髋（56.2%），髋关节发育不良58髋（22.4%），髋关节骨性关节炎36髋（14.0%），股骨颈骨折11髋（4.3%），类风湿关节炎8髋（3.1%）。采用 Harris 评分、疼痛视觉模拟评分（VAS）及临床并发症评估患者髋关节功能，随访X 片观察假体有无松动、螺钉有无断裂等。结果：所有患者均安全度过围手术期。术后1例患者出现肺部感染伴胸腔积液，术后6例患者术侧大腿出现了不同程度的疼痛，术后5例患者出现假体感染，术后6例患者出现脱位，术后7例患者出现小腿肌间静脉血栓，术后15例患者出现了假体下沉，未出现无菌性松动或神经血管损伤等并发症，无翻修患者，股骨柄存活率为100%。术后239例（258髋）均获随访，随访时间0.5~7年，平均5.8年，末次随访Harris评分（84.84±5.65）分、VAS评分（1.11±0.79），所有的股骨柄都非常稳定，没有透亮线的迹象。结论：Corail HA 全涂层股骨柄假体具有持久的稳定性，术后大腿疼痛发生率较低等优点，中期疗效较好。

Observation on the mid-term clinical effect of Corail femoral stem prosthesis in 258 hips

Objective: to investigate the medium-term effect of Corail hydroxyapatite (Hydroxyapatite,HA) fully coated femoral stem prosthesis for total hip arthroplasty ((Total hip arthroplasty, THA)) in patients with end-stage hip disease. Methods: the clinical data of 239 patients (258hips) with end-stage hip disease treated with THA with Corail prosthesis from October 2011 to October 2019 were analyzed retrospectively, including 137males and 102females, aged from 38 to 79 years (mean 50.4 years). There were 117 cases of left hip and 141 cases of right hip. Indications include avascular necrosis of the femoral head in 145 hips (56.2%), hip dysplasia in 58 hips (22.4%), hip osteoarthritis in 36 hips (14.0%), femoral neck fractures in 11 hips (4.3%), and rheumatoid arthritis in 8 hips (3.1%). The function of hip joint was evaluated by Harris score, visual analogue scale of pain ((VAS)) and clinical complications. Follow-up X-ray was used to observe the loosening of the prosthesis and the fracture of the screw. Results: all patients survived the perioperative period safely. After operation, 1 patient developed pulmonary infection with pleural effusion, 6 patients had varying degrees of pain in the thigh, 5 patients had prosthesis infection, 6 patients had dislocation after operation, 7 patients had intermuscular vein thrombosis of leg after operation, 15 patients had prosthesis subsidence after operation, and there were no complications such as aseptic loosening or neurovascular injury. There were no revision patients, and the survival rate of femoral stalk was 100%. 239 cases (258 hips) were followed up for 0.5 ~ 7 years (mean 5.8 years). The Harris score and VAS score of the last follow-up were 84.84 ±5.65 and 1.11 ±0.79. all the femoral stalks were very stable and there was no sign of transparent line. Conclusion: Corail HA fully coated femoral stem prosthesis has the advantages of long-term stability, low incidence of postoperative thigh pain and good mid-term effect.