摘要
目的:评价短柄全髋关节置换术对股骨头坏死的治疗效果.方法:从我院选择2009-06/2012-12接受陶瓷对陶瓷短柄全髋关节置换术治疗的股骨头坏死的患者38例(40髋),其中男性23例,女性15例,平均年龄32.6±18.2岁,并且Steinberg分期均为Ⅳ期以上.21例从后外侧入路,17例采用前外侧入路,术后即刻、6个月、12个月以及随后每年都进行随访,摄骨盆正位以及髋关节侧面X线片,测量假体下沉距离,采用Harris髋关节评分和WOMAC骨关节指数评估关节功能.结果:36例(38髋)患者获得随访,平均随访时间为32.4个月,最后一次随访假体较术后下沉(0.71±2.88)mm,差异无统计学意义(P>0.05).术后髋关节疼痛均明显改善,Harris髋关节评分术前为(37.9±11.9)分,末次随访为(95.6±4.8)分,差异有统计学意义(P<0.05),WOMAC骨关节指数术前为(67.1±11.9),末次随访为(12.7±5.8),差异有统计学意义(P<0.05).结论:短柄全髋关节置换术能够更多地保留骨量,假体初始稳定性好,全陶瓷头衬配伍的磨损率低,疗效佳,相关并发症少.
AIM：To evaluate the clinical effects of short stem ceramic-on-ceramic total hip arthroplasty in the treatment of pa-tients with femoral head necrosis.METHODS：From June 2009 to December 2012,38 patients with femoral head necrosis were treated primarily with short stem ceramic-on-ceramic hip arthro-plasty （40 hips）through posterior-lateral or anterior-lateral ap-proach.There were 23 males and 15 females,with the mean age of （32.6 ±18.2）years old.All cases were stage IV or more ac-cording to Steinberg stage.The patients were followed up at right after operation,the 6,12 months after operation and then once each year.Standard X-ray films were taken at the follow ups. Femoral pmsthesis subsidence was assessed through X ray films. Harris scores system and WOMAC Osteoarthtitis Index were recor-ded before and after operation to evaluate clinical effects of surger-y.RESULTS：Thirty-six patients （38 hips）were followed up for about 32.4 months.The femoral stem subsided （0.71 ±2.88） mm at the last follow up.After operation,hip pain of patients was relieved obviously.The Harris score improved from （37.9 ± 11.9）preoperatively to （95.6 ±4.8 ）postoperatively,while WOMAC Index from （67.1 ±11.9）to （12.7 ±5.8）.CON-CLUSION：The short stem hip arthroplasty preserves bone stock to a great extent.The short stem implant showed a good stability and osseous integration.The weal rate of cemmic-on-ceramic beating surface is extremely low.Short stem hip arthroplasty plus ceramic-on-ceramic beating surface might be a good option for the patients with femoral head necrosis.
出处
《转化医学电子杂志》
2015年第1期127-129,共3页
E-Journal of Translational Medicine
关键词
髋关节
股骨头坏死
置换
hip joint
osteonecrosis of the femoral head
replace-ment
