应用LCU股骨柄假体行全髋置换术的早期疗效

目的探讨应用LCU股骨柄假体行生物学固定型全髋关节置换术(total hip arthroplasty,THA)的早期疗效。方法回顾性分析2011年8月至2013年4月采用LCU股骨柄假体行THA术85例(90髋),男26例(28髋),女59例(62髋);年龄19~83岁,平均55岁;平均体重指数(23.33±3.13)kg/m2。单髋80例,双髋5例。发育性髋关节发育不良34例(38髋),股骨颈骨折14例(14髋),股骨头坏死17例(17髋),原发性髋关节骨关节炎18例(19髋),类风湿性髋关节炎1例(1髋),髋关节结核1例(1髋)。股骨侧假体均采用LCU股骨柄假体。髋臼采用陶瓷-陶瓷界面者78髋,陶瓷-聚乙烯12髋。对术后及随访时的影像学资料进行分析,末次随访时采用髋关节Harris评分标准评定疗效。结果 82例(87髋)患者术后获得随访,随访12~32个月,平均19个月,3例失访。术前髋关节功能Harris评分为(33.73±3.21)分,末次随访时髋关节功能Harris评分改善至(92.84±4.47)分,与术前比较差异有统计学意义(t=242.69,P0.01)。末次随访时大腿轻度疼痛1例,中度疼痛1例,无重度疼痛。末次随访时无一例出现骨溶解、假体松动,按Engh标准评定:所有获访者均获骨长入固定,其中股骨侧假体诊断为骨性固定者85髋,诊断为纤维性稳定者1髋。假体下沉小于2 mm者1髋,其余均无假体下沉。结论 LCU股骨柄假体行生物学固定型THA的早期疗效满意。

Short-term Results of Total Hip Arthroplasty with a LCU Femoral Stem

Objective To investigate the short_term results of total hip arthroplasty（THA）with a LCU femoral stem. Methods From August 2011 to April 2013,LCU flat tapered stems were used for THA in 85 patients（90 hips）. There were 26 males and 59 females,at a mean age of 55 years（range,19 ～ 83 years）. Their body mass index was（23. 33 ± 3. 13）kg/ m2 . Eighty patients underwent unilateral THA and five bilateral THA. There were 34 cases of developmental dysplasia of the hip（38 hips）,14 femoral neck fractures（14 hips）,17 avascular necrosis of the femoral head（17 hips）,18 primary hip osteoarthritis （19 hips）,1 rheumatoid hip arthritis（1 hip）and 1 case of tuberculosis of the hip joint（1 hip）. Ceramic on Ceramic interface were used in 78 hips,while ceramic on polyethylene interface were used in 12 hips. Postoperative X_ray data were analyzed and the clinical efficacy was assessed at the final follow_up by Harris Hip Score. Results Eighty_two patients（85 hips）were avail_able for an average follow_up of 19 months（range 12 to 32 months）. Before operation,the Harris score was（33. 73 ± 3. 21） points. At the final follow_up the Harris hip score was（92. 84 ± 4. 47）points,showing significant difference compared to preop_erative score（t = 242. 69,P ＆lt; 0. 01）. There was one patient with mild pain in the thigh,one with moderate pain,but none with severe pain at the final follow_up. At the final follow_up there were no cases of osteolysis or prosthesis loosening. All patients a_chieved a stable bony fixation as assessed by the Engh criteria. Periprosthetic bone ingrowth on the femoral side was achieved in 88 hips and fibrous stable fixation in one hip;one showed signs of prosthesis subsidence except for one hip with a ＆lt; 2 mm prosthetic subsidence. Conclusion The LCU femoral stem can result in good to excellent short_term clinical results in patients undergoing cementless T