摘要
目的 比较金属对金属（MOM）大直径全髋关节置换术后与金属对聚乙烯（MOP）全髋关节置换术后的近期疗效.方法 2007年6月至2008年12月采用髋关节后外侧入路对30例（30髋）进行MOM大直径全髋关节置换术（MOM组）,男12例,女18例;平均年龄60.3岁;平均体质量指数23.7 kg/m2;术前Harris评分平均为（36±15）分.同期采用后外侧入路对30例（30髋）进行MOP全髋关节置换术（MOP组）,男9例,女21例;平均年龄62.4岁;平均体质量指数23.4 kg/m2;术前Harris评分平均为（34±17）分.对两组患者的术后功能恢复及影像学进行比较.结果 术后随访12～18个月（平均14.4个月）,两组患者均未发生感染、骨折脱位及神经损伤等并发症,MOP组有1例患者术后2个月形成深静脉血栓.术后1、3、6、12个月Harris评分MOM组平均分别为（86±3）、（90±3）、（95±4）、（92±4）分,MOP组平均分别为（78±4）、（84±3）、（90±4）、（92±4）分.术后1、3、6个月两组Harris评分比较差异均有统计学意义（P＜0.05）.术后MOM组髋关节总活动范围平均为239.2°±21.9°,屈髋平均为135.4°±10.9°;MOP组髋关节总活动范围平均为190.1°±16.7°,屈髋平均为95.3°±11.3°,差异有统计学意义（P＜0.05）.结论 MOM大直径全髋关节置换相比传统MOP全髋关节置换短期疗效好,其中远期疗效需进一步观察.
Objective To compare the short-term results of metal-on-metal （MOM） and metal-on-polyethylene （MOP） bearing surfaces in total hip replacement （THR）. Methods Thirty cases, 12 males and 18 females, received MOM THR through a posterolateral surgical approach from June 2007 to December 2008. Their mean age was 60.3 years, mean body mass index （BMI） was 23.7 g/m2 and mean Harris score was 36 ± 15 preoperatively. For comparison, another 30 cases, 9 males and 21 females, received MOP THR through the same approach at the same period. Their mean age was 62.4 years, mean BMI was 23.4 kg/m2 and mean Harris score was 34 ± 17 preoperatively. The 2 groups were compared in terms of hip functional recovery and radiographic examination. Results All patients obtained an average follow-up of 14.4 months （range, 12 to 18 months） . No infection, fracture or neurovascular injury occurred in either group. There were one deep venous thrombosis and one dislocation in the MOP group. The average Harris scores at 1, 3, 6, 12 months postoperatively were respectively 78 ±4, 84 ±4, 90 ±3, 92 ±4 for the MOP group and 86 ± 3, 90 ± 3, 95 ± 4, 95 ± 3 for the MOM group. The differences between the 2 groups were significant at 1, 3, 6 months （ P 〈 0.05） but insignificant at 12 months （ P 〉 0.05）. In the MOM group,the total range of hip motion averaged 239.2°± 21.9° and the hip inflexion averaged 135.4°± 10.9°. In the MOP group, the total range of hip motion averaged 190.1°± 16.7° and the hip inflexion averaged 95.3°± 11.3°. The differences between the 2 groups were significant （ P 〈 0.05）. Conclusion On a short-term basis, MOM THR may be better than MOP THR, but the medium and long-term results of MOM bearing surfaces still need further investigation.
出处
《中华创伤骨科杂志》
CAS
CSCD
2010年第10期940-944,共5页
Chinese Journal of Orthopaedic Trauma
关键词
关节成形术
置换
髋
假体和植入物
治疗结果
Arthroplasty, replacement, hip
Prostheses and implants
Treatment outcome
