国产髋关节人工假体置换术后生存率的远期随访

A long-term follow-up of survival rate of the hip prosthesis made in China

目的 :通过远期随访了解国产髋关节人工假体置换术后生存率。方法 :对本组 176例髋关节人工假体置换术后有回信和Harris评分的病例采用临床生存率进行统计。对X线资料完整的 92例采用X线生存率进行统计。结果 :本组 176例的临床生存率 :5年 15 8例 ( 90 % ) ;10年 13 0例 ( 73 % ) ;15年 3 2例 ( 18% ) ;2 0年 12例( 7% )。本组 92例的X线生存率 :5年 5 7例 ( 67% ) ;10年 40例 ( 4 4% ) ;15年 10例 ( 11% ) ;2 0年 2例 ( 1% )。在 10～ 15年X线生存率 5 0例中的年龄分布是 5 0～ 60岁。这说明 5 0～ 60岁是髋关节人工假体置换的较好适应证。另外 ,2 0年X线生存率和临床生存率的平均年龄是 45岁。这也说明此年龄段的骨质和体质相对较好。在 10年和 15年X线生存率中男女比例无明显差异。但在 5年和 2 0年X线生存率中女性所占比例较大。可能与 5年X线生存率的高龄女性骨质疏松和 2 0年X线生存率中的女性活动量比男性相对较少有关。从 2 0年临床生存率的 12例中没有见到肥胖者 ,间接说明体重对假体磨损有一定影响。本组人工假体 5年平均下沉 4mm ;10年平均下沉 9mm ;15年平均下沉13mm ;2 0年平均下沉 19mm ;2 5年平均下沉 2 2mm。平均每年下沉 1mm。结论 :从本组 176例国产髋关节人工假体置换术后随访结果?

Objective:To investigate the survival rate of a long-term follow-up.Method:In a long-term follow-up,the clinical survival-rate of hip prosthesis made in China in 176 cases were evaluated using questionnaire and Harris scale.The radiological survival-rate of the prosthesis were investigated in 92 cases with consecutive radiological data.Result:The clinical survival-rate were as follows:5 years in 158 cases(90%),10 years in 130 cases(73%),15 years in 32 cases(18%),over 20 years in 12 cases(7%).The Radiological survival-rate were as follows:5 years in 57 cases(67%),10 years in 40 cases(44%),15 years in 10 cases(11%),over 20 years in 2 cases (1%).The age distribution of the 50 patients with a prosthesis survival-rate of 10～15 years were from 50 through 60 year-old.This result suggested that the patients with age of 50～60 should be the ideal candidates for hip arthroplasty.The average age of the patients with both the clinical and radiological survival-rate of 20 years was 45,indicating that the younger patients are with better bone quality and in good health state.No significant gender difference was recorded in the patients with the radiological survival-rate of 10 and 15 years,but female prevalence was found in those with survival rate of 5 and 20 years.Osteoporosis and lower activity could be associated to the female prevalence in the 5-year survival-rate group and 20-year survival-rate group,respectively.None obesity patient was found in clinical survival-rate of 20 years,implying the impact of body weight upon the prosthesis abrasion.The mean prosthesis subsidence was 4mm in 5 years,9mm in 10 years,13mm in 15 years,19mm in 20 years and 22mm in 25 years(about 1mm per year).Conclusion:This long-term follow-up result of the hip prosthesis made in China suggests that the prosthesis survival-rate patients(especially women)with age of over 80 and poor health condition is only 5 years;the survival-rate in the patients with age of 50～60 and no associated disease is 10～15 years.The factors correlated to the survival-rate of over 20 years are summarized as follows:younger patients(40～50 year-odl),no obesity,no associated disease,light labor and less physical activity.