摘要
目的分析人工髋关节置换术后翻修的原因,评价全髋翻修术的临床效果。方法本组33例34髋。初次关节置换类型:全髋置换21例,双杯髋关节置换1例,人工股骨头置换11例。翻修原因:无菌性松动23例24髋,髋臼位置不良1例1髋,股骨头置换后髋臼磨损5例5髋,感染4例4髋。翻修距初次手术时间:1年以内5髋,1～2年1髋,5～10年18髋,10～13年10髋。翻修假体类型:非骨水泥型假体20髋,混合型假体7髋,骨水泥型假体7髋。结果平均随访3.5年。1例术后半年发生股骨柄松动进行再翻修,其余病例假体保留,优良率为82.4%。结论翻修的最常见原因为无菌性松动,人工股骨头置换时髋臼磨损也是翻修原因之一,对较年轻的股骨颈骨折患者,如行假体置换,最好采用全髋关节置换。翻修术采用非骨水泥型假体较好。
Objective To analyze the reason of revision total hip replac ement and evaluate the clinical outcome. Methods We reviewed a consecutive serie s of 34 hips in 33 patients who were ready for the revision of total hip replace ment. There were 10 males and 23 females, with a mean of 62.5 years. The primary diseases of the hip joint were avascular femoral necrosis 20 cases, femoral nec k fracture 11 cases, osteoarthritis secondary from the acetabular dysplasia 1 ca ses, ankylosing spondylitis 1 case. The first operations were total hip replacem ent 21 patients, double cup surface total hip replacement 1 patient (2 hips) a nd femoral head replacement 11 patients. The reason of revision included of loos ening 24 hips, acetabular failure position 1 hip, acetabular erosion 5 hips, and infection 4 hips. The survival duration from the first operation to the revisio n was less than 1 year for 5 hips, 1 to 2 years for 1 hip, 5 to 10 years for 18 hips, and 10 to 13 years for 10 hips. The methods for revision were cementless c omponent 20 hips, hybrid arthroplasty (a cementless acetabular component and a c emented femoral component) 7 hips, and cemented arthroplasty 7 hips. The follow up was 0.5 year to 13 years, with a mean of 3.5 years. Results One patient ha d a femoral stem rerevised in half a year because of loosening. Other components survive at the last follow up. The rate of good and excellent was 82.4% . Co nclusion The commonest reason of revision is loosening. Acetabular erosion is th e main reason of revision in femoral head replacement. Total hip replacement is better than femoral head replacement for the younger patients with femoral neck fracture. cementless arthroplasty yields good results. [
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2001年第12期738-740,共3页
Chinese Journal of Orthopaedics
