保留股骨颈人工全髋关节置换术后5年以上随访的临床疗效

目的评价保留股骨颈全髋关节置换术后5年以上的临床疗效及术后并发症。方法2000年9月至2012年9月，本科室通过保留股骨颈全髋关节置换术治疗各种髋关节疾病152例，其中5年以上随访46例。本文对46例患者术后随访x线片、Harris评分、肢体的长度、关节活动度及并发症进行回顾性分析。结果围手术期并发症包括：术中股骨干骨折5例，脱位1例，切口无感染，未出现深静脉血栓及肺栓塞。随访时间5—12年，平均7．6年。末次随访Harris评分由术前平均41．2分（17—60分）提高到术后平均82．3分（74～96分），其中38例评分大于80分，6例评分位于70～80分之间，2例评分小于70分。影像学检查2例髋臼假体、1例股骨假体周围出现小范围的透亮线，其余x线片示髋臼和股骨柄假体位置满意，无松动及下沉现象，股骨颈骨质良好。结论保留股骨颈全髋关节置换治疗髋关节骨关节病中期疗效满意，尤其适用于可能需要行假体翻修的中青年患者。

Clinical and Radiographic Results of Total Hip Arthroplasty with Coilum Femoris Preserving Pros- thesis：an over 5 Years Follow Up

Objective To evaluate the clinical results and complications of total hip arthroplasty with collum femoris preserving prosthesis（CFP） over five years. Methods Between September 2000 to September 2012,152 patients underwent total hip arthroplasty with CFP prosthesis. There were 46 cases were fellowed up over 5 years （5 - 12 years）. Clinical outcomes were evaluated by Harris score. Components migration and complications were assessed according to the anteriorposterior and lateral X ray of the hips. Results The average Harris score improved from 41.2 before operation to 82.3 postoperative. According to Harris functional assessment at last follow-up, the results were excellent in 38 hips, good in 6 hips, and fair in 2 hips. There were some perioperative complications including 5 cases of femoral fracture and 1 case of hip dislocations one week after operation. The survival rates of the cups and stems were all 100% at last follow-up. Conclusion THR with CFP prosthesis is a good option for the young patient with complete collum femoris and without osteoporosis, and can achieve good mid-term effect.