二种人工全髋关节置换治疗股骨头坏死44例

目的 采取无柄全髋关节及有柄全髋关节置换方案治疗股骨头坏死,分析二组治疗效果.方法 股骨头坏死患者44例45髋,无柄全髋关节置换组18例19髋,有柄全髋关节置换组26例26髋,所有患者均获得3年以上随访.记录手术时间、失血量、术中和术后与手术或内植物有关的并发症,选取术前、术后3年随访时进行Harris评分并比较.结果 经过3年以上的随访,二组手术时间、失血量、并发症及患者的住院时间相比较差异无统计学意义.Harris评分无柄关节组及有柄全髋关节置换组二组间差异无统计学意义(P＞0.05).结论 无柄全髋关节与有柄全髋关节置换相比,早期疗效差异无统计学意义.

THE EFFECT OF TWO KINDS OF TOTAL HIP ARTHROPLASTY FOR AVASCULAR NECROSIS OF THE FEMORAL HEAD IN 44 PATIENTS

Objective To compare the effect and complications of two hip replacements(stemless hip prosthesis,and Traditional total hip arthroplasty) for avascular necrosis of the femoral head.Methods A total of 44 cases of avascular necrosis of the femoral head were selected from January 2005 to June 2009.They were respectively treated with stemless hip prosthesis(n=18),and traditional total hip arthroplasty(n=26).All patients were followed up at least for 3 years.The patients were evaluated preoperative and 3 years after surgery by Harris score,X-ray,hip and prosthesis-related adverse reaction and revision.Results During the 3-year follow-up,no revision was performed in any group,and the Harris scores were not significant difference in the two groups(P>0.05).The present study showed that compared with stemless hip prosthesis and total hip arthroplasty,the functional recovery of the treatment for avascular necrosis of femoral head might be no more difference in the early stages postoperative.Conclusion The treatment of stemles hip prosthesis can preserve collum femoris and more bone,so the revision surgery will be easier than the traditional total hip arthroplasty.