组配式假体在人工全髋关节翻修术中的应用

探讨组配式假体在全髋关节翻修术中的应用方法及临床疗效。方法：2008年6月至2011年6月采用非水泥型组配式翻修假体对23例患者行人工全髋关节翻修术。男12例,女11例。年龄52～85岁,平均年龄63岁。首次髋关节置换术至翻修术时间15月至17年,平均7年。初次人工髋关节置换术前诊断股骨颈骨折10例,股骨头缺血性坏死10例,髋关节先天发育性不良3例。翻修的原因：其中无菌性松19例,髋关节感染3例,假体周围骨折1例。23例患者均为首次翻修。术中并发症：骨干皮质穿孔1例,大转子部分劈裂1例。结果23例患者手术后刀口均为I期愈合,无下肢DVT及肢体不等长,术后髋关节脱位等并发症的发生。23例患者均获得随访,时间8～36个月。随访期间未出现假体松动下沉,假体周围感染周围骨长入良好。术前Harris评分平均为为48,末次随访平均86分。与手术前比较P〈0.05有统计学意义。结论采用组配式翻修假体行人工全髋关节翻修术效果明显,可以调节长度,偏心距,前倾角可以独立匹配远近端股骨,达到初期与长期的假体稳定性。

Application of prosthesis in total hip arthroplasty

Exploring prosthesis in total hip arthroplasty and clinical efficacy.Methods：June 2008 to June 2011 using non-cement-based in 23-style renovation prosthesis patients,12 males and 11 females,aged 52-85 years,mean age 63 years.For the first time hip replacement surgery to renovation surgery is for 15 months to 17 years,on average 7 years.Primary total hip replacement preoperative diagnosis of femoral neck fracture in 10 cases,10 cases of avascular necrosis,congenital hip adverse in 3 cases.Renovation of the reasons：19 cases in which aseptic loose hip infection in 3 cases,periprosthetic fracture in 1.23 patients were first renovated.Intraoperative complications：the backbone of cortical perforation in 1 case,part of the greater trochanter split in 1 case.Results：23 patients were stage I after surgery incision healing,no lower extremity DVT and limb length,postoperative hip dislocation and other complications.23 patients were followed up for 8 to 36 months.compared Before surgery with p0.05 considered statistically significant.Conclusions：The treatment group effect is obvious,can adjust the length,eccentricity,inclination,achieve initial and long-term implant stability.