保留股骨颈型髋关节假体置换治疗晚期青壮年股骨头坏死中期随访研究

目的 观察保留股骨颈型人工髋关节假体治疗晚期青壮年股骨头坏死的中期疗效.方法 对2002年8月至2009年11月接受置换5年以上的21例28髋青壮年股骨头坏死骨关节炎并接受保留股骨颈型髋关节置换的患者资料进行回顾性分析.患者年龄26～51岁,平均36岁;其中男性16例22髋,女性5例6髋.对随访患者行Harris髋关节评分,拍摄X线片了解假体的位置以及有无松动、远端有无骨质吸收情况.术前Harris评分平均48.5分.结果 2例患者失访,19例26髋获得随访,随访时间63～85个月,平均67个月.3例患者出现下肢不等长,但长度差异＜2 cm.无大腿疼痛发生,无一例患者行髋关节翻修.末次随访时Harris评分平均90.2分.结论 保留股骨颈型髋关节假体置换治疗晚期青壮年股骨头坏死中期疗效满意.

Total hip replacement with collum femoris preserving for the treatment of advanced stage of femoral head necrosis of young patients: a report of results of more than five years follow-up

Objective To observe the results of total hip replacement with collum femoris preserving for the treatment of advanced stage of femoral head necrosis of youth. Methods From August 2002 to November 2009,21 patients (28 hips) with advanced stage of femoral head necrosis were treated with total hip replacement with collum femoris preserving. Sixteen males(22 hips) and 5 females (6 hips)with an average age of 36 years (range from 26 to 51 years) were included. All patients were evaluated clinically using Harris score, the prosthesis components were assessed for position, loosening, bone resorption and other conditions with radiographs. Results Nineteen patients (26 hip) were followed up formean 5 years and 7 months (ranging 5 years and 3 months to 7 years and 1 month) ,2 patients were missed.The average Harris score increased from the preoperative average 48.5 to 90. 2. The leg-length discrepancy ( the difference was less than 2 cm) occurred in 3 cases. No thigh pain and revision. Conclusion Total hip arthroplasty with collum femoris preserving is one of the best choices for the treatment of advanced stage of femoral head necrosis of yong patients with good midterm outcome.