人工髋关节置换术治疗258髋股骨头坏死临床分析

目的:分析股骨头坏死人工髋关节置换术的临床疗效。方法:总结1980年9月￣2004年6月我科行人工关节治疗股骨头坏死患者232例(258髋),其中单纯头置换5髋,双极头43髋,全髋置换210髋,采用北京普鲁斯公司、Landos、LINK及Zimmer假体,术后随访1～11年,平均5.6年。比较手术前后的髋关节功能Harris评分,进行放射学等分析,评估股骨头坏死人工关节置换术各型术式的临床疗效。结果:成组设计秩和检验单纯头、双极头、全髋术后5、10年随访评分差异有显著性(P<0.05)。双极人工股骨头置换术的疗效要逊于全髋置换术,单纯头置换疗效较差。比较人工髋关节术后5、10年随访翻修差异有显著性(P<0.05)。全髋置换术明显优于单纯头、双极头人工关节置换术。结论:人工髋关节置换术治疗晚期股骨头坏死,改善患者生活质量方面疗效佳。双极人工股骨头置换术的疗效要逊于全髋置换术,单纯头置换疗效较差。

Clinic analysis of 258 cases avascular necrosis of the femoral head by operation treatment of hip prosthesis replacement

Objective To summarize the therapeutic experience of 258 cases avascular necrosis of the femoral head by operation treatment of hip prosthesis replacement. Method This article focuses in 232 clinic cases in which patients are all given hip prosthesis replacement due to ANFH.We make a long-term follow-up which contains age,gender,type of prosthesis,therapeutic effect of operation and analysis of these dada. We give Harris score due to patients' joint function before and after operation and do a statistical analysis. Results According to the harris scores (5 and 10 years after operation)by statistical analysis,the therapeutic effect of three type of prosthesis replacement have significant difference. Conlusion The bipolar-head replacement is prior to pure-head one,but inferior to total hip replacement.