国产人工全髋关节置换33髋随访

背景：全髋置换治疗严重髋关节疾病在国内的应用已越来越多。然而，目前的主流假体都是基于西方人的解剖数据而设计的，是否适合体型相对较小的东方人应用，存在一定争论。针对这一问题，在亚洲，包括中国，针对东方人的假体设计不断出现，但对其疗效观察的数据却并不多见。 目的：随访由国内自行设计制造的双动全髋假体的置换效果。 方法：对1987-06/1996-12在吉林大学中日联谊医院/附属临床医院骨科施行全髋关节置换的33髋进行随访。所应用假体为北京钢铁研究院设计生产的一种双动式全髋假体，其设计类似于目前的双动股骨头假体之外，再加上一聚乙烯髋臼假体。固定方式为骨水泥固定，采取第一代骨水泥固定技术。假体置换时平均年龄56.6岁，平均随访8.5年。通过临床评分及X射线影像学结果来分析治疗效果。 结果与结论：临床评分总优良率为68.6%。影像学检查发现髋臼松动16髋(48.5%)，股骨假体松动11髋(33%)，异位骨化11髋(33%)。另外发现感染2髋，脱位1髋。此假体的应用取得了一定的疗效。但受当时条件所限，该假体在设计、骨水泥技术上都存在一定问题，有待进一步改进。

Follow-up of total hip replacement using domestic prosthesis in 33 hips

BACKGROUND: Total hip replacement has been widely used in the treatment of severer hip diseases in China. However, most of prostheses are designed according to Caucasian osteometric measurements, whether those prostheses are suitable for Orientals is still in dispute. It is emerging to design prostheses for Orientals, there are few reports addressing therapeutic effect after replacement. OBJECTIVE: To follow up the long-term results of total hip replacement using domestic designed dual-assembly total hip prosthesis. METHODS: Totally 30 patients (33 hips) who underwent total hip replacement at the Department of Orthopaedic Surgery, China-Japan Union /Affiliated Hospital of Jilin University, from June 1987 to December 1996, were followed up. The designed dual-assembly total hip prosthesis was produced by Central Iron & Steel Research Institute, which was similar to bipolar prosthesis with a polyethylene acetabular cup. First generation cementing techniques were applied. The average age at the time of the operation was 56.5 years (30-81 years) and the average follow-up period was 8.5 years (5.0-14.4 years). Standard anteroposterior radiographs of the hip and clinical examinations were used to analyze therapeutic efficacy. RESULTS AND CONCLUSION: The total excellent and good rate was 68.6%. The imaging examination showed that there were 16 hips (48.5%) had aseptic loosening and 11 hips (33%) had heterotrophic bone formation. Additionally, two cases suffered from infection and one case suffered from dislocation. The utilization of prosthesis achieved certain curative effects. However, the design and cement technology have problems due to limitation of conditions, which should be solved in further experiments.