非骨水泥人工髋关节翻修术60例临床分析

Clinical analysis of primary revision cementless total hip replacement for failed hip arthroplasty in 60 cases

目的探讨人工关节置换术后假体松动的原因及翻修技术。方法2001-05～2005-11对60例采用非骨水泥全髋关节翻修术,男42例,女18例；年龄35～71岁,平均54．2岁。翻修原因除1例感染性松动外,其余均为无菌性松动。32例患者获得随访,随访时间为5～63个月,平均31个月。结果Harris评分由术前的平均40．6分升高至术后平均80．4分。术后所有患者双下肢均恢复或保持等长,髋关节疼痛缓解。无1例患者发生感染或髋关节脱位。结论非骨水泥股骨翻修假体能够极大地方便髋关节翻修术,近期X线检查和临床效果满意。

Objective To study the reason and revision technology of terminal aseptic loosening of total hip replacement.Methods Retrospective study was done on revision of cementless total hip replacement in 60 cases who were admitted from May 2001 to November 2005.There were 42 males and 18 females, with age ranging from 35 to 71 years （mean 54.2 years）.All the cases were aseptic loosening but one infective loosening.Results All the cases were followed up for six to twenty four months （average 31 months）. Harris＇ score was 40.6 points preoperatively and 80.4 points postoperatively.All the cases remain the same length of lower limbs and all pains of hip joint were alleviated. There was no hip joint infection or dislocation but two femoral fracture in operation.Conclusion The revision cementless total hip will benefit the failed hip arthroplasty and has satisfactory short-term radiographic evaluation and clinical effect.