双极股骨头置换术及其关节活动的观察

Bipolar Femoral Head Replacement and Its Mo-tion Studies

１９８５年１月～１９８９年５月施行双极人工股骨头置换术３８例，２９例随诊１～５年（平均３６．３月）。依疼痛、关节功能及关节活动度逐项评定，优良率为８０．８％，３例失败（１１．５％），原因系假体构型不良，假体安放位置不佳及骨水泥技术的缺陷。对１０例不同病因及术后时间不等的置换关节在透视下动态观察内外关节活动方式，发现小范围活动时，以内关节活动为主，而大范围活动时，以外关节为主。提出提高疗效的措施，即改进假体设计，假体安放在中立位及改进骨水泥技术。

AbstractFrom Jan 1985 to May 1989,38 cases of differenthip lesions were operated on with bipolar femoral headprosthesis.2 9 cases were followed-up for 1 to 5 years(an average 36.3 months). According to pain,jointfunction and motion,the excellent and good resultswere seen in 80.8%.The failure occured in 3 cases(11.5%).The causes were improper selection of theprosthetic type,malposition of prosthesis , and draw-back of cement technique. Cineroentgenographic stud-ies were carried out on 10 hips in different postopera-tive periods.It revealed the motion occured dominant-ly on the inner-bearing joint when the hip movementwas in a lesser arc(flextion less than 90°,abductionless than 40°). When the hip movement increased,theouter-bearing joint slipped over acetabular cartilage.The results could be improved by using a modern typeof prosthesis, modern cement technique,the place-ment of the prosthesis in neutral position.