金属对金属人工全髋表面置换术的临床应用

目的 探讨金属对金属人工全髋表面置换术治疗类风湿性关节炎和股骨头无菌性坏死的临床价值。方法 从1995年1月至1996年12月，对16例患者17个髋关节（其中类风湿性关节炎14个，股骨头无菌性坏死3个）行混合型金属对金属人工全髋表面置换术，术后行问卷调查、髋关节功能检查、X线和Harris评分分析，平均随访58.2月。结果 所有患者没有一例行翻修手术，X线显示所有表面置换假体植入位置满意，没有假体松动、移位现象出现。问卷调查显示患者对16个髋关节的术后情况表示非常满意。Harris评分平均指数从术前的44（31～52）分提高至术后的91(79～96分）。结论 金属对金属人工全髋表面置换术不失为患类风湿性关节炎和股骨头无菌性坏死的年青患者为保存关节功能，改善疼痛的一种有价值的治疗方法。

Metal on Metal Surface Replacement of Hip in Young Patients with Rheumatoid Arthritis of Aseptic Necrosis of Femoral Head

Purpose Present study investigated the role of metal on metal surface replacement of the hip in treating the young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head. Methods Between Jan.1995 and Dec.1996.16 patients with 17 hips(rheumatoid arthritis 14, aseptic necrosis of femoral head 3)were resurfaced with hybrid metal on metal surface replacement prothesis.Patients were evaluated by self assessment form,hip function examination.Radiographs and Harris hip score.The average follow up time was 58.2 months. Results No patient received revision.Radiographs showed that all implants were in position satisfyingly.No loosening were revealed.The result of self assessment showed that patients were satisfied with 16 hips.The Harris score rose from preoperative 44(31-52) to postoperative 91(79-96). Conclusions The metal on metal surface replacement of hip is a useful treatment to release pain and keep the hip function of young patients suffering rheumatoid arthritis or aseptic necrosis of femoral head.