人工髋关节翻修术的临床原因分析及假体的选择研究

目的探讨人工髋关节置换术后翻修的临床原因及假体的选择。方法共纳入50例人工髋关节置换术患者,按照距首次行置换术大于或小于5年分为早期组(30例)及晚期组(20例),并按照年龄是否大于50岁分为2组(各25例)。均详细记录患者的病史及行翻修术的原因。结果感染性松动、无菌性松动、假体的磨损、假体周围骨折、关节不稳定均是患者行翻修术的原因,但早期与晚期患者行翻修术的主要原因不同;早期行翻修术的主要原因是感染性松动、假体周围骨折、关节不稳定,而晚期行翻修术的主要原因为无菌性松动、假体的磨损。对于老年患者选择骨水泥型假体较好,而对于更年轻点的患者选择生物型假体较好。结论早期行翻修术与晚期行翻修术的主要原因不同,因根据具体情况治疗。对于老年患者选择骨水泥型假体较好,而对于更年轻点的患者选择生物型假体较好,临床可以根据研究对不同患者选用合适的假体。

Analysis on clinical causes of revision surgery of artificial hip and choice of prosthesis

OBJECTIVE The purpose of this study was to investigate clinical causes of revision surgery of artificial hip and choice of prosthesis.METHODS 50 hospitalized patients with revision of artificial hip were enrolled.According to time to the first replacement surgery longer or shorter than 5 years,the patients were divided into early group(30 cases)and advanced group(20 cases).And according to age whether older than 50 years,the patient were divided into two groups(25 cases in each group).Recorded the patients’ case history and causes of revision procedures.RESULTS Infectious loosening,aseptic loosening and wear of false body,fractures around prosthesis,unstable joint were the causes of revision procedures,but patients in the early group and the advanced group had different causes of revision procedures;the main causes of patients in the early group were infectious loosening,fractures around prosthesis and unstable joint,and the main causes for patients in the advanced group were aseptic loosening and wear false of body.For older patients,it should choose bone cement type prosthesis,but for the younger patients,choosing biological type prosthesis was better.CONCLUSION The main causes of early and advanced revision procedures are different,it should take treatments according to the specific circumstances.For older patients,it should choose bone cement type prosthesis,but for the younger patients,choosing biological type prosthesis is better.According to different clinical study,patients are given with suitable prosthesis.