APL生物解剖固定股骨柄假体THA术疗效研究

目的 探讨APL生物解剖固定股骨柄假体人工全髋关节置换术(THA)的临床疗效。 方法选择60例股骨头无菌性坏死病人，其中28例病人接受APL生物解剖固定股骨柄假体THA术治疗，32例病人接受骨水泥型假体THA术治疗，分别设为观察组与对照组。记录2组病人手术相关指标以及并发症发生情况，手术前、术后1个月、末次随访评价疼痛视觉模拟评分(VAS)、髋关节Harris功能评分(HHS)及骨关节炎评分指数(WOMAC)。 结果 观察组手术时间、双下肢不等长程度显著低于对照组，差异均有统计学意义(P < 0.01)，2组术中出血量、住院时间差异均无统计学意义(P>0.05)。2组术后1个月、末次随访VAS评分均低于术前，HHS评分、WOMAC评分均高于术前，末次随访VAS评分均低于术后1个月，HHS评分、WOMAC评分高于术后1个月，差异均有统计学意义(P < 0.01)；术前、术后1个月组间比较差异无统计学意义(P>0.05)；末次随访，2组VAS评分差异无统计学意义(P>0.05)，观察组HHS评分、WOMAC评分均高于对照组(P < 0.01)。2组并发症发生率差异无统计学意义(P>0.05)。 结论APL生物解剖固定股骨柄假体THA术治疗股骨头无菌性坏死切实可行，近期疗效显著，术后假体稳定性较高，双下肢等长良好。

Study on the effects of APL bioanatomical fixation of femoral stem prosthesis THA

ObjectiveTo explore the clinical effects of APL bioanatomical fixation of femoral stem prosthesis artificial total hip arthroplasty(THA). MethodsAmong 60 patients with aseptic necrosis of femoral head, 28 cases were treated with APL bioanatomical fixation of femoral stem prosthesis THA(observation group), and 32 cases were treated with bone cement-type prosthesis THA(control group).The operation-related indicators and complications were recorded in two groups.The visual analog scale(VAS), Harris hip functional score(HHS) and osteoarthritis score(WOMAC) were evaluated before surgery, after 1 month of surgery and at the last follow-up. ResultsThe operation time and unequal length of both lower limbs in observation group were significantly lower than those in control group(P < 0.01).There was no statistical significance in the intraoperative blood loss and hospital stay between two groups(P>0.05).For the two groups after 1 month of surgery and at last follow-up, the VAS scores were significantly lower than those before surgery, and the HHS score and WOMAC score were significantly higher than those before surgery(P < 0.01).The VAS score at the last follow-up was lower than after 1 month of surgery, while the HHS score and WOMAC score were higher than after 1 month of surgery in two groups(P < 0.01).The VAS score, HHS score and WOMAC score between two groups before surgery and after 1 month of surgery were not statistically significant(P>0.05).At the last follow-up, the difference of VAS scores between two groups was not statistically significant(P>0.05), and the HHS score and WOMAC score in observation group were significantly higher than those in control group(P < 0.01).There was no statistical significance in the incidence rate of complications between two groups(P>0.05). ConclusionsThe APL bioanatomical fixed femoral stem prosthesis THA is feasible in the treatment of aseptic necrosis of femoral head, and the short-term curative effect is significant.The postoperative prosthesis is stable, and the lower limbs are of good equal length.