大头径陶瓷-陶瓷全髋关节置换的早期疗效

背景：36mm大直径陶瓷球头较28mm常规直径陶瓷头增加了跳越距离,具有活动范围大,稳定性好,脱位率低等特点,适用于年轻,要求活动范围大,追求高生活质量患者。目的：观察36mm大头径陶瓷-陶瓷全髋关节假体行关节置换的早期疗效。方法：2009-06/2010-07采用Depuy公司的Pinnacle TM36mm大头径陶瓷-陶瓷全髋假体行初次人工全髋关节置换治疗18例（18髋）髋关节疾病患者。对照组为同期行Pinnacle TM28mm直径陶瓷-陶瓷人工全髋关节置换治疗20例（20髋）髋关节疾病患者。结果与结论：所有患者均获得随访,随访时间13～26个月。置换后切口均Ⅰ期愈合,未发生假体脱位、感染及下肢深静脉血栓形成等并发症。两组患者置换后Harris各项评分较置换前均明显改善（P〈0.05）,且直径36mm组置换后活动范围评分较直径28mm组改善明显（P〈0.05）;但两组置换后Harris总评分及疼痛、功能评分比较差异无显著性意义（P〉0.05）。结果初步表明现代陶瓷-陶瓷人工关节假体能有效减少因关节界面磨损导致的骨溶解及关节松动等并发症。36mm大头径陶瓷-陶瓷全髋假体设计具有活动范围大，稳定性好，脱位率低等特点，在术中条件允许情况下，可作为首选型号。

Early clinical efficiency of large femoral head in ceramic-on-ceramic total hip arthroplasty

BACKGROUND：36 mm large diameter of femoral head increases more jump distance than 28 mm diameter of femoral head,which has the characteristics of large range of motion,good stability and few dislocations.It can be appied to young patients,requiring large activities range and high quality of life.OBJECTIVE：To observe early clinical efficacy of 36 mm diameter of femoral head in ceramic-on-ceramic total hip arthroplasty.METHODS：From June 2009 to July 2010,18 hips in 18 patients with hip disease were treated with total hip arthroplasty using Depuy PinnacleTM 36 mm diameter of large femoral head in ceramic-on-ceramic total hip prosthesis.Control group （20 cases） were treated by total hip arthroplasty with Depuy PinnacleTM 28 mm diameter of femoral head in ceramic-on-ceramic total hip prosthesis in the same period.RESULTS AND CONCLUSION：All the patients were followed up from 13 months to 26 months,incisions got primary healing without complications such as prosthesis dislocation,infection and deep venous thrombosis postoperation.Postoperative total Harris score of the two groups was more significant improved as compared with those of the two groups preoperative （P〈0.05）.Postoperative range of motion score in the 36 mm group was improved more significantly than that in the 28 mm group （P〈0.05）.However,the two groups had no significant difference in postoperative total Harris score,pain score and function score （P〉0.05）.Modern ceramic on ceramic hip prosthesis can effectively decrease the complications of osteolysis and prosthetic loosening caused by wearing of joint interface.36 mm diameter of femoral head in ceramic-on-ceramic total hip arthroplasty has the characteristics of large range of motion,good stability and few dislocations.It can be used as the first choice if the intraoperative conditions permit.