保留股骨颈联合陶瓷-陶瓷全髋关节置换术的初步应用体会

目的通过对32例保留股骨颈联合陶瓷-陶瓷人工全髋关节置换术的临床疗效进行回顾分析,探讨保留股骨颈联合陶瓷-陶瓷全髋关节置换术初步体会。方法选取自2006年4月-2013年6月间在我院行保留股骨颈联合陶瓷-陶瓷全髋关节置换术的32（34髋）例患者,其中男14例（14髋）,女18例（20髋）,平均年龄43.5岁,随访时采用Harris髋关节评分标准进行临床评价,通过影像学了解假体位置、松动情况。结果本组32例患者均得到访,平均随访时间48（16-108）个月,术前Harris评分平均（50.53±4.3）分提高到术后平均（91.55±3.5）分,与术前比较差异有统计学意义（P〈0.01）。影像学检查示,随访期间未见假体松动、下沉、碎裂,未发生假体周围感染、骨折,无关节异响、翻修,无可观察到的磨损和骨溶解,无明显异位骨化,1例患者术后1周出现假体脱位,1例患者术后3周出现下肢深静脉血栓。结论保留股骨颈联合陶瓷-陶瓷人工全髋关节置换术治疗65岁以下、骨质良好并且对生活质量要求较高,身体运动量较大的患者短期随访效果满意,但远期疗效需更长期的随访以验证。

Primary application experience of femoral neck with ceramic on ceramic total hip arthroplasty retention

Objective To review the clinical curative effects of 32 cases of femoral neck preservation with ceramic total hip arthroplasty. Methods From 2006 April to 2013 June in our hospital 32 （34hips） patients, including 14 males （14hips） , 18 females （20hips） , average age 43.5, followed by Harris hip score standard clinical evaluation. Results In this group,32 patients were surveyed, the average follow-up time were 48 （16-108） months, the mean preoperative Harris score （50.53± 4.3） points,and the average postoperative （91.55 ± 3.5） %, （P〈0.01） .Imaging examination showed,during the follow-upperiod,no prosthesisloosening, no fragmentation, without the occurrences of periprosthetic infection, fracture, no joint noise, observable wear osteolysis, and heterotopic ossification. Prosthesis dislocation occurred in 1 patient and lower extremity deep venous thrombosis in 1 cases. Con- elusion The preservation of femoral neck in the ceramic total hip arthroplasty in patients below 65 years old, is with good and higher requirements for the quality of life of patients.