摘要
[目的]研究非骨水泥型全髋关节置换术治疗酒精性股骨头坏死的中期疗效。[方法]1997年3月～2002年6月,采用非骨水泥型全髋关节置换术治疗酒精性股骨头坏死41例(47髋),进行至少5年的随访、中期临床评估和影像学评估。临床评估以Harris评分为标准。影像学根据骨盆正位和髋关节侧位X线片,观察髋臼、股骨假体的位置以及周围骨质的改变。假体的生存率采用Kaplan-Meier分析,分别以股骨、髋臼假体的无菌性松动和任何原因所致的翻修为终点。[结果]得到至少5年随访的41例(47髋),术前Harris评分为42.4±6.4(24～49)分,最后1次随访评分为91.8±4.4(74～100)分。至最后1次随访时无1例翻修或表现为影像学无菌性松动,2髋出现骨盆局灶性骨溶解,6髋出现股骨局灶性骨溶解。Kaplan-Meier分析假体的生存率1.0(95%可信区间,0.98～1.0)。[结论]非骨水泥型全髋关节置换术可为晚期酒精性股骨头坏死患者提供良好的中期临床效果。由于假体磨损、假体周围骨溶解等潜在因素,长期效果需要进一步随访。
[Objective]To study the mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic osteonecrosis of the femoral head.[Method]From March 1997 to June 2002,41patients（47 hips） was treatmented by cementless total hip arthroplasty,the mid-term （equal to or more than 5 years） results were evaluated both clinically and radiographically.Clinical outcomes were evaluated according to Harris evaluation score. Components migration,bone changes around the implant were measured radiologically. Kaplan-Meier analysis was performed to evaluate the surviving rate of the femoral and acetabulum components. End point was radiographical loosening or revision of the acetabular and femoral component for any reason.[Result]Forty-seven hips in 41 patients were followed up at least 5 years. The mean Harris hip score increased from preoperation（42.4±6.4）points to （91.8±4.4） points at the time of final follow up. No component was loose,No component was revised. The focal area of pelvic osteolysis in 2 hips and small focal area of femoral osteolysis in 6 hips were found. The surviving rate of the femoral and acetabulum components,was 1.0（95% confidence interval,0.98 to 1.00）.[Conclusion]The mid-term outcomes about cementless total hip arthroplasty in the treatment of patients with alcoholic necrosis of femoral head had been satisfactory. Because the wear of component,osteolysis can not be avoided,clinical and radiographical follow-up for cementless total hip arthroplasty must be carried out persistently.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2007年第18期1385-1387,共3页
Orthopedic Journal of China
关键词
股骨头坏死
酒精
全髋关节置换
非骨水泥型
alcoholic
necrosis of femoral head
total hip arthroplasty
cementless
