人工全髋关节置换翻修术术前假体松动的回顾性研究

目的通过对48例人工全髋关节置换翻修术术前资料的系统回顾性研究,评价采取不同固定方法的假体的临床疗效。方法笔者对行髋关节置换的48例实行了全髋翻修术,并对全部病例进行了术前X线评价及术中假体松动情况调查,并做χ2检验,判断不同假体固定方式对假体寿命的影响。结果早、中期假体松动主要为非骨水泥型假体。骨水泥固定的假体与非骨水泥固定的假体远期均存在很高的松动下沉率,以骨水泥臼的松动为多数。髋臼侧骨溶解发生率以Ⅰ区为高,股骨柄侧骨溶解发生率以股骨近端为最高。结论人工全髋关节置换术中生物性固定初期并不十分牢固。人工全髋关节置换术中骨水泥固定假体松动主要发生在远期,并且以髋臼侧骨水泥松动为主。

Curative Effect Analysis of Fixation Methods for Total Hip Arthroplasty

Objective To analyze and evaluate the clinical curative effect of total hip arthroplasty in different kinds of fixation methods. Methods Forty- eight patients undergoing the hip revision received the radiographic evaluation before operation and were investigated in prosthesis loosening during the operation. Results According to Harris score, loosening mainly occurred in cementless prosthesis in its early and middle term. The rate of the bone osteolysis was the highest in acetabular I zone and in femoral I , VI , ~, and zones. The rate of osteolysis of cement fixation and cementless fixation prostheses was high in the long term. Conclusion The biological fixation of total hip arthroplasty is not firm in the primary phase. Prosthesis loosening of cement fixation in the total hip replacement mainly occurs in the long term and at the acetabular. We use improved technology of cement in the total hip replacement.