中青年髋关节疾病行金属对金属全髋关节表面置换术的疗效及安全性

目的 探讨中青年髋关节疾病患者行金属对金属人工全髋表面置换术的可行性.方法 选择各类髋关节疾病患者28例（35髋）,年龄28 ～ 54岁,平均42岁;其中股骨头缺血性坏死16例、骨性关节炎5例、先天性髋关节发育不良4例和创伤性关节炎3例.患者均行混合型金属人工全髋表面置换术,术后检查髋关节功能、计数Harris评分、评估疼痛程度、观察髋关节影像学形态.结果 28例平均随访34个月,髋关节功能优32髋,良2髋,可1髋,优良率96.9％.未发现股骨颈骨折、股骨头坏死及假体固定失败等并发症.结论 金属对金属全髋关节表面置换术治疗中青年髋关节疾病近期疗效满意,可作为传统全髋置换术的过渡性手术.

Efficacy and safety of metal-on-metal resurfacing of total hip in young patients with hip disease

Objective To investigate the feasibility of metal-on-metal surface arthroplasty （MMSA） of total hip in young patients with hip disease.Methods Thirty-five hips in 28 patients （28-54 years old with average age of 42 years）,which included 16 case of osteonecrosis （ON）,5 cases of osteoarthritis （OA）,4 cases of developmental dysplasia of the hip （DDH） and 3 case of traumatic arthritis （TA）,were treated with hybrid prothesis of MMSA.All patients were evaluated by self assessment form,hip function examination,radiographs,occurrence of pain,preoperative and postoperative Harris hip score.Results Twenty-eight patients were followed up for 10-75 （mean 34） months.After the operation,2 hips had mild pain,1 hip had moderate pain,and no patients reported marked pain with the good rate of 96.9％.There was no occurrence of complications such as femoral neck fracture,osteonecrosis and failure of fixation etc in all patients.Conclusion The short-term results of MMSA in treatment of young patients with hip disease are satisfied,and MMSA can be taken as a best transitional solution for the conventional total hip arthroplasty.