髋臼侧骨缺损全髋关节翻修中的早期疗效分析

目的：通过对全髋关节翻修术后随访病例进行分析,探讨髋臼侧翻修时处理各类型骨缺损的方法选择及其早期疗效。方法：对46例髋关节置换术后髋臼骨缺损的患者进行翻修,观察术后随访X线片上的髋臼假体及周围骨质变化情况,并对髋关节行Harris功能评定和VAS评分。结果：46例获得随访,随访时间13~83个月,平均随访41.8个月,髋关节Hariss评分平均由全髋关节翻修术前的（53.15±11.41）分（29~67分）提高至翻修术后12月的（91.23±3.43）（83~98分）（P〈0.05）。疼痛视觉模拟评分（VAS）评分平均由全髋关节翻修术前的（7.8±1.1）分（5~10分）减低至翻修术后12月的（1.2±1.2）分（0~3分）（P〈0.05）。结论：全髋关节翻修术中,根据不同的翻修原因给予不同的植骨方式和选择适当的假体类型,可有效恢复髋关节周围骨量,重建髋关节的稳定性,改善髋关节的功能,近期随访疗效均满意。

Analysis of treatment of acetabular bone defect in revision of total hip arthroplasty and early therapeutic effect

Objective： To study the treatment of vanous types of acetubular bone defect in revision of total hip replacement and early efficacy. Methods： 46 cases of acetabular bone defect after hip replacement were rerised and followed up.The acetabular prosthesis and bone changes were observed by X-ray, and the hip function was assessed by Harris score and VAS score. Results： 46 cases were followed up for 13~83 months（average 41.8months）.The average Harris score from 53.15 ± 11.41 in creased to 91.23 ± 3.43 after revision（P 〈0.05）;the VAS score from 7.8 ± 1.1 reduced to 1.2 ± 1.2（P 〈0.05）. Conclusion： In total hip arthroplasty revision,using different grafting methods and choosing proper type of prostesis according to different causes,can effectively restore the hip bone,reconstruction of the stability of hip joint, and improve the function of the hip joint. Followup results are satisfactory.