金属对金属髋关节表面置换术治疗重度股骨头无菌性坏死的短期临床效果

目的探讨新一代的金属对金属髋关节表面置换术治疗重度股骨头无菌性坏死（FicatⅢ、Ⅳ）的短期临床效果。方法对28例（33髋）诊断为股骨头无菌性坏死的患者行金属对金属髋关节表面置换手术。股骨头无菌性坏死程度按照Ficat分期：Ⅲ期24例（27髋），Ⅳ期4例（6髋），手术时的平均年龄是48岁（21-77岁），其中男患者17例（60.7%），女患者11例（39.3%）。术后随访内容包括所有患者的临床及影像学资料。结果平均随访时间为24个月（11-35个月），在随访期内未发生髋关节脱位、深静脉栓塞、感染、股骨颈骨折等并发症。临床结果显示，Harris髋关节评分较术前显著提高，术后平均Harris评分为92.6分，术前平均Harris评分为48.5分。影像学资料显示所有假体在位，未观察到放射性透亮带。所有患者疼痛解除，髋关节活动度也明显改善，术后早期活动无任何受限。结论金属对金属髋关节表面置换术治疗重度股骨头坏死的早期临床效果满意，其远期效果仍有待于观察。

Short-term clinical outcomes of metal-on-metal hip resurfacing in osteonecrosis of the femoral head

Objective To investigate the short-term outcomes of metal-on-metal hip resurfacing in serious osteonecrosis of the femoral head. Methods 28 consecutive patients （33 hips） with osteonecrosis of the femoral head underwent metal-on-metal resurfacing arthroplasty. 24 cases （27 hips） were diagnosed Ficat Ⅲ, and 4 cases （6 hips） were diagnosed Ficat Ⅳ. The average age at the time of surgery was 48 years （21~77 years）. 17 patients （60.7%） were male and 11 （39.3%） were female. Clinical and radiographic results were observed. Results All patients were followed up for a mean of 24 months （11~35 months）, During the follow-up period, no complications such as dislocation of the hip joints, deep venous embolism, infection or femoral neck fracture occurred. The mean postoperative Harris hip score was 92.6 to 48.5 preoperatively. The radiographic analysis showed all prostheses were fixed with no radiolucencies. Besides the pain is nearly completely relief, the range of motion is remarkable improved. Conclusion The short-term results for metal-on-metal hip resurfacing for this group of patients with serious osteonecrosis of the femoral head were excellent. We await long-term results to see if these early results are maintained.