摘要
目的评估Zweymüller非骨水泥型全髋关节置换术后5—11年疗效。方法对1996至2002年由同一术者完成且应用Zweymüller假体的初次全髋关节置换术患者进行随访，包括临床评估和放射学评估。结果共116例142髋符合纳入标准，61例77髋获得随访，随访时间为5～11年，平均7．3年。其中50例64髋同时获临床及放射学评估，5例6髋只获得临床评估，6例7髋只获得放射学评估，随访率为52．6％。Harris评分由术前平均46分提高至末次随访时平均93分，51髋（72．9％）术后疼痛在1个月内缓解，术后扶拐行走时间平均为2个月。x线片随访见远端骨皮质肥厚30髋（42．3％），髓内骨化33髋（46．5％），异位骨化45髋（63．4％）。无一例髋臼侧出现透亮带，27髋（38．0％）股骨侧可见透亮带。7髋（9．9％）髋臼侧出现骨溶解，18髋（25．4％）股骨侧出现骨溶解。虽然无已行翻修病例，但3髋因髋臼明显松动移位需行翻修术。以翻修手术或需行翻修手术作为失败的标准，髋臼杯5～11年假体存活率为95．8％，股骨柄的存活率为100％。结论Zweymüller假体术后5～11年随访总体疗效令人满意，但骨溶解发生率高。
Objective To analyze the intermediate-term results associated with the use of Zweymüller hip system. Methods Review the 116 cases （142 hips ） who were treated with total hip replacement from 1996 to 2002 by a single surgeon using cementless Zweymüller hip systems. Results Sixty- one cases （77 hips） were followed up, 50 cases （64 hips） were evaluated both clinically and radiographically while 5 cases （6 hips ） and 6 cases （7 hips ） were only evaluated clinically and radiographically respectively. The average follow-up period was 7.3 years （range 5 to 11 years）. The mean preoperative Harris Hip Score was 46 while the mean postoperative Harris Hip Score was 93. Distal conical hypertrophy and medullary sclerosis were observed in 30 hips（42. 3% ） and 33 hips（46. 5% ） respectively. Heterotopie ossification arose in 45 hips （63.4%）. Radiolucent lines occured in 27 stems（38.0% ） but in no cups. Radiolucent lines were mostly observed in Gruen zones 1. Osteolysis occurcd in 7 cups （9. 9% ） and 18 stems （25.4%）. Osteolysis was mostly observed in Delee Zone 3 and Gruen zone 7. In the distal Gruen zones 3, 4 and 5, no radiolucent line or osteolysis was observed. No hips had been revised, 3 cups needed revision surgery because of aseptic loosening. Conclusion The 5-11 years follow-up results are satisfactory, but osteolysis is common.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第13期1020-1023,共4页
Chinese Journal of Surgery
关键词
关节成形术
置换
髋
随访研究
髋假体
Athroplasty, replacement, hip
Follow-up studies
Hip prosthesis
