中年患者128例生物型全髋置换和骨水泥全髋置换后的随访比较

背景：许多学者均认为骨水泥型全髋置换适合应用于年老且合并较严重的骨质疏松患者,生物型全髋置换适用于较为年轻的患者。目的：对比中年患者生物型全髋置换和骨水泥型全髋置换的临床效果。方法：对比分析58例骨水泥型全髋置换者与70例生物型全髋置换者置换后6个月、2年及5年的肢体功能恢复与影像学评估结果以及Harris评分,均为40～60岁中年患者。结果与结论：生物型假体置换后6个月、2年、5年的Harris评分明显优于骨水泥型假体（P〈0.05）,5年生存率也高于骨水泥型假体（P〈0.05）。骨水泥型假体置换后6个月,3例发生自发溶骨性疾病,3例2年后发生假体松动,3例5年后发生线性渗透溶;生物型假体置换2年后2例发生自发溶骨性疾病,置换后5年1例发生假体松动。说明生物型假体较骨水泥型假体更能促进中年患者置换后髋关节功能的恢复,减少并发症的发生,至少在5年的随访过程中获得了更令人满意的临床和影像学结果。

Follow-up comparison of 128 middle-aged patients with uncemented total hip arthroplasty and bone cement total hip arthroplasty

BACKGROUND：Many scholars think that bone cement total hip arthroplasty is suitable for old aged patients with serious osteoporosis,while uncemented total hip arthroplasty is applicable to young patients.OBJECTIVE：To compare the clinical effect of uncemented total hip arthroplasty and bone cement total hip arthroplasty on middle-aged patients.METHODS：The limbs functional restoration,radiological evaluation and Harris score of 58 cases with bone cement total hip arthroplasty and 70 cases with uncemented total hip arthroplasty was detected at 6 months,2 and 5 years,respectively.All these 128 patients were middle-aged patients（40-60 years old）.RESULTS AND CONCLUSION：Statistical data showed that the Harris score of uncemented prosthesis,as well as the 5-year survival rate after 6 months,2 and 5 years was significantly better than cement type prosthesis（P 0.05）.Three cases had osteolysis at 6 months after cement type prosthesis arthroplasty,3 cases had prosthesis loosing at 2 years after arthroplasty and 3 cases appeared linear permeability dissolvement at 5 years after arthroplasty.Two cases had osteolysis at 2 years after uncemented prosthesis arthroplasty and 1 case had prosthesis loosing at 5 years after arthroplasty.Uncemented prosthesis achieved a high rate of functional restoration and a low rate of complications.Uncemented total hip arthroplasty in middle-aged patients had a satisfactory clinical and radiographic outcome at a minimum of 5 years follow-up.