珊瑚型人工髋关节置换术的临床随访及松动原因的分析

自１９８３年至今应用珊瑚型人工髋关节置换术共５４例６０髋。其中人工全髋关节置换术３４例４０髋，人工股骨头置换术２０例２０髋。在５４例６０髋珊瑚型人工髋关节置换术中，有３７髋随访６个月～１３年，平均随访时间约７年，疗效满意率为８５．１％，其中假体松动４例占１４．８％，髋臼松动２例７．４％。假体松动原因是假体与股骨负重界面之间没有达到稳定接触，假体与髓腔形状不相匹配，修整髓腔松质骨时，髓腔扩大器应比假体小一号，避免假体与界面存留缝隙。对于髋臼发育不良的患者应避免髋关节旋转中心向外侧移位，应向内上方加深髋臼以减少水平移位距离，其次髋臼植骨加盖勿在负重区。

Coralline Hip Arthroplasty: A Long Term Follow-up Study and Analysis of Prothesis Loosening

Since May 1983, coralline hip arthroplasty was performed on 60 hips (54 cases). Porous total hip arthroplasty (THA) was used in 40 hips (34 cases), and hemi arthroplasty in 20 hips (20 cases). The average follow up period of porous THA was 83.9 months (6 months to 10 years). Good results were achieved in 85.1% of the patients. Four hips (14.8%) had loosening of the femoral components, and two hips (7.4%) had loosening of the acetabular components. Analysis of the clinical data revealed that, femoral component loosening was due to unstable contact of the prothesis with bone, which including unsuitable prothesis or reamer was used. The reamer should be smaller than the prothesis to minimize the space between the prothesis and medullary cavity. In cases of hip dysplasia, the author recommends placing the acetabular component more proximal instead of a lateral position to the center of the hip. The author no longer advocates the use of bone graft for acetabular reconstruction.