Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on early postoperative gait restoration in patients undergoing total hip arthroplasty （THA）. Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads （conventional group） and for 12 THAs （BHR group） using metal-on-metal femoral heads with an average size of 45 mm （range, 40-49mm）. All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length （SL）, single limb support （SLS）, cycle duration （CD）, and swing power （SP）. Harris Hip Scores and gait analysis parameters for both groups were compared. Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harristm postop - HarriSpreop and Harris3m postop- HarriSpreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal - SLaffected, （SLSnormal - SLSaffected）/CD, and SPnormal - SPaffected in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected, （SLSnormal- SLSaffected）/CD, and SPnormal - SPaffected were not significant, but the mean of SPnorrnal - SPaffected in the BHR group was significantly lower than that in the conventional group. Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.     

全髋关节置换术治疗伴有股骨头坏死的成人髋关节发育不良

目的:总结人工全髋关节置换术治疗伴有股骨头坏死的成人髋关节发育不良的经验及术后效果.方法:分析我科2006年4月至2010年6月间诊治的29位伴有股骨头坏死的成人髋关节发育不良患者的临床资料及随访结果,并进行统计学处理.共行38髋全髋关节置换术,平均随访20个月.结果:平均手术时间109 min,平均术中失血量390 ml,围术期无重大心脑血管并发症发生,平均Harris评分术前为39.3分,术后随访为84.3分(P＜0.05),手术效果优良率为96%.结论:全髋关节置换术是治疗伴有股骨头坏死的成人髋关节发育不良的一种重要方法,术者对该病病理特点的熟练掌握、周密的术前准备、丰富的手术经验是手术取得成功的关键.     

肥胖对全髋关节置换术后的早期疗效影响分析

目的 探讨肥胖对全髋关节置换术(THA)后的早期疗效影响分析。方法 对我科2014年11月至2016年9月期间300例需要行THA的患者根据入院时人体质量指数(BMI)分为肥胖组(107例,BMI≥25)与非肥胖组(193 例,BMI＜25),比较两组患者术中和术后出血量、手术时间、术后3个月内并发症发生率(假体骨折、脱位、感染、深静脉栓塞),并分别在术后1、2、6个月时间比较患侧髋关节Harris评分变化,将以上数据并进行统计学分析。结果 肥胖组和非肥胖组相比较,前者在术中和术后出血量、手术时间、深静脉栓塞及术后3个月内并发症总数发生率均高于非肥胖组,差异具有统计学意义(P＜0.05);而术后假体脱位、假体骨折及感染的发生率,肥胖组虽然高于非肥胖组,但差异无统计学意义(P＞0.05)。术后第1、2、6个月的髋关节Harris评分非肥胖组高于肥胖组,差异具有统计学意义(P＜0.05)。结论 肥胖会增加THA术中难度,增加THA术后早期并发症的发生率,同时对患者术后早期髋关节的功能恢复有影响。     

激素性股骨头缺血性坏死全髋关节置换疗效观察与分析

目的:观察激素性股骨头缺血性坏死全髋关节置换术后疗效。方法:对解放军总医院1986年3月至1996年3月间的激素性股骨头缺血性坏死全髋关节置换患者进行术后随访观察,取创伤组作对照。采用Harris髋关节功能评分并进行X线评价。结果:激素组松动率较高,2组松动率具有显著差异(P<0.05)。激素组翻修率3.6%,创伤组无一例翻修。结论:激素性股骨头缺血性坏死全髋关节置换疗效相对较差。     

股骨头坏死的部位与人工全髋表面置换术后股骨颈骨折的相关性研究

目的:通过生物力学实验探讨股骨头坏死缺损的部位与人工全髋表面置换术(MMSA)后发生股骨颈骨折的相关性。方法:选取成年人股骨标本25具,要求生前无髋关节疾患。将其随机分组,分别制造股骨头不同部位(负重区与非负重区)的骨缺损模型(模拟已发生塌陷并且坏死骨被清除后的股骨头缺血坏死模型)。将标本分为正常组、股骨头负重区域的坏死缺损10%、20%与非负重区域的坏死10%、20%,共5组。均在股骨头表面覆盖相匹配的金属假体,模拟单足站立时肢体负重力线的方向,加载一定的重量,直至股骨颈发生骨折为止。并分析股骨头不同坏死部位与股骨颈骨折发生的生物力学相关性。结果:股骨头负重区域坏死的股骨颈强度比非负重区坏死的强度来得小,易发生变形和骨折,差异具有统计学意义(P<0.001)。结论:股骨头负重区域坏死对MMSA术后股骨颈的影响较大,易发生股骨颈骨折。股骨头负重区坏死>20%是MMSA术的相对禁忌证,术后易发生股骨颈骨折。     

人工关节置换术治疗高龄患者创伤性股骨头坏死

目的探讨人工关节置换术治疗高龄患者创伤性股骨头坏死的适应证与临床效果。方法1995年以来，采用人工关节置换术治疗高龄患者创伤性股骨头坏死30例30髋。男8例，女22例，年龄70～85岁，平均74．6岁。骨坏死病史平均0．8（0．5～1）年。均为股骨颈骨折后发生股骨头坏死。其中，股骨颈骨折头下型26髋，经颈型4髋（但骨折线斜向股骨头下）。20例原行切开或闭合复位内固定（钢针或螺钉），18例骨折不愈合，2例骨折愈合，但均于术后0．5～1年发生股骨头坏死。10例为保守治疗或仅卧床休息，于伤后8个月骨折未愈，发生股骨头坏死。患者均有髋部疼痛和功能障碍。采用人工全髋关节置换术12髋，双动人工股骨头18髋。其中，混合型假体6髋，骨水泥型假体置换24髋。结果术后病人疼痛解除，关节功能明显改善。平均随访时间3．5（1～8）年，髋关节Harris评分由术前的平均35分改善为85分。优良率为88．3％。混合型假体和骨水泥型假体中，各发生股骨柄松动下沉1髋。结论高龄患者创伤性股骨头坏死可采用人工全髋关节置换术治疗。     

人工髋关节置换术后股骨假体周围骨折9例治疗分析

目的 分析人工髋关节置换术后股骨假体周围骨折的病因、治疗方法和效果.方法 回顾分析9例人工髋关节置换术后股骨假体周围骨折的临床资料.其中2例非手术治疗,3例使用非骨水泥型股骨假体,1例使用骨水泥型股骨假体,3例使用植骨和记忆合金环抱器.结果 2例非手术治疗骨折者1例未愈合,1例愈合,7例手术治疗者骨折全部愈合.结论 假体稳定的A型骨折可以非手术治疗,B2型骨折使用非骨水泥柄假体,B1型和C型骨折使用植骨和记忆合金环抱器.     

全髋关节置换术和人工股骨头置换术治疗股骨颈骨折的疗效分析

目的比较全髋关节置换术和人工股骨头置换术治疗股骨颈骨折的疗效.方法选取我院进行治疗的股骨颈骨折患者142例,分为观察组和对照组,观察组采用全髋关节置换术治疗,对照组采用人工股骨头置换术治疗,比较疗效.结果观察组优秀率为49.30%,优良率为91.55%,对照组优秀率为28.17%,优良率为77.46%,差异显著(P<0.05);观察组生理功能、躯体疼痛、生理职能、社会功能、活力和总体健康评分显著高于对照组(P<0.05).结论全髋关节置换术用于股骨颈骨折的治疗,相对于人工股骨头置换术,其治疗效果好,术后患者生活质量高.     

保留股骨颈型人工全髋关节置换术92例

目的探讨保留股骨颈型人工全髋关节置换术的疗效。方法 2000年9月—2010年9月,我科开展保留股骨颈型人工全髋关节置换术92例（104髋）,其中男50例,女42例,年龄20～65岁。结果本组经过0.5～10年随访,92例人工全髋关节置换术后,髋关节功能良好。影像学检查显示人工髋关节位置良好,假体无松动和下沉。结论保留股骨颈型人工全髋关节置换符合股骨近端生理顺应性,能防止股骨近端骨质疏松引起假体松动和下沉。     

全髋关节置换术后脱位的原因分析及防治对策

目的 探讨全髋关节置换术(THA)后脱位的原因及防治措施.方法 回顾分析2000年3月至2008年12月9例THA术后脱位患者的术前病因、脱位原因、治疗经过及术后预防再次脱位采取的措施.结果 术后经6个月至8年随访,其中7例未再发生脱位,1例伴有偏瘫患者反复出现脱位,另1例在6个月内再次出现脱位后经限制患髋活动,未再出现脱位.结论 髋关节周围软组织失衡、患肢主动或被动活动范围过大、假体安装位置不当是脱位的常见原因;脱位后大多数患者可通过麻醉下行闭合复位治疗,少数假体位置不当且稳定实验阳性者应考虑手术翻修;术前和术后对患者进行有关THA的康复知识教育是预防脱位的重要措施.     

全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的疗效比较

目的比较全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折的疗效。方法选取2016年1月~2017年1月在本院住院治疗的老年股骨颈骨折60例,年龄≥60周岁,其中30例采取全髋关节置换术,设立为A组,30例采取人工股骨头置换术,设立为B组,比较两组的手术时间、术中出血量、术后下床活动时间、Harris髋关节功能评分、术后并发症情况。结果 B组采用人工股骨头置换术的手术时间短于A组、术中出血少于A组,组间比较差异具有显著性(P0.05)。A组的术后下床活动时间(12.3±2.4)d、明显短于B组,组间比较差异具有显著性(P0.05)。A组采用全髋关节置换术的Harris髋关节功能评分优良率明显高于B组,组间比较差异具有显著性(P0.05)。两组术后均无一例发生切口感染、坠积性肺炎及褥疮等近期并发症。其中,A组发生远期并发症包括假体松动1例、异位骨化1例,B组发生远期并发症包括髋臼磨损1例、异位骨化1例,两组比较,差异无显著性(P0.05)。结论全髋关节置换术与人工股骨头置换术治疗老年股骨颈骨折均为有效的治疗方法之一,但人工股骨头置换术具有手术时间短、术中出血少的优点,而采取全髋关节置换术患者的髋关节功能改善效果更好。