32例国产人工髋关节翻修手术的临床体会

目的：探讨国产人工髋关节翻修原因。方法：回顾总结32例人工髋关节翻修中发现的问题，分析翻修原因。结果：32例中术前诊断松动16例，脱位4例，深部感染2例，白磨通3例，断柄2例，髋周及股部疼痛4例，股骨柄穿通皮质1例。26例取出假体顺利，6部部分骨长入珍珠面而取出假体困难。25例作全髋置换翻修，4例臼怀松动或位置不良致脱位仅翻修髋臼，1例股骨柄穿通皮质更换双动头，2例因深部感染严重而作单纯假体取出、清创术。全组病例经6个月－5年随访，Harris评分术前平均43分，术后平均81分，平均增加38分。结论：目前翻修病例仍以国产人工关节为主。翻修原因主要是：人工关节质量因素和手术技术因素。造成假体过早松动或种种其它并发症，最终失败。提示国产人工关节质量需改进，需相应配套器械，手术操作技术有待提高。

Clinical Experience of 32 Cases of Revision for Domestic Hip Joint Replacement

Objective:To investigate the reasons for revision of domestic hip prostheses.Methods:Thirty two cases of revision total hip replacement were reviewed.The reasons for revision were analyzed.Results:Reading the causes of reoperation,16 cases were bacause of aseptic loosening,4 cases dislocation,2 cases deep infection,2 cases breaking,1 cases perforation and 4 cases thigh or hip pain.Among the 32 cases,25 cases of revision total hip replacement,2 cases of removal protheses,4 cases of revision acetabular component and 1 cases of revision bipolar were performed respectively.All cases were followed up for 6 months to 5 years(average 3.5yrs).Harris'score system showed that the score were raised from 43 points preoperation to 81 points postoperation(average raised 38 points).Conclusion:At present,the major cases of revision are due to the quality of domestic hip prostheses and the operative technique.All these factors induce early aseptic loosening and other complications.It is emphasized that the quality of domestic prostheses and the operative technique shoud be improved expectantly.