糖尿病患者人工髋关节置换的中期疗效及相关因素分析

Artificial Joint Replacement in Patients with Type 2 Diabetes Mellitus: 18 Cases Mid-term Follow-up

目的探讨2型糖尿病伴发股骨颈骨折患者行人工关节置换术的中期临床疗效及影响因素。方法对18例2型糖尿病伴发股骨颈骨折行人工髋关节置换术患者平均随访（45．5±13．1）个月（23—86个月），随访项目包括：Harris髋评分和髋关节X线检查，空腹血糖水平记录及糖尿病相关检查。结果除3个高龄患者需扶单杖外均可自由行走及上下楼梯，X线复查13例正常，4例发生髋臼缘骨质增生，其中2例间隙变窄，2例股骨柄有轻微下沉。Harris评分平均为（81．9±14．8），Harris评分与患者年龄无相关性，与体重指数、空腹血糖水平呈负相关。结论糖尿病患者植入人工关节使用良好；控制体重并监控血糖在适当范围内有重要意义。

Objective To evaluate the feasibility of artificial joint replacement in patients complicated with type 2 diabetes mellitus （DM）. Methods 18 patients with DM accepted the artificial joint replacement after fracture at the femoral neck, They were followed-up with the Harris hip score and radiographs for average 45.5 months （range 23-86 months）. The fasting blood glucose （FBG） levels and other associated indexes were monitored during the periods after operation. Results All the patients can walk freely except 3 elder patients that walk with the help of crutch. Radiographic studies showed that 13 cases were excellent, osteophytes appeared around acetabulum in 4 cases, among which 2 cases had the decrease in the hip joint space, and the subsidence appeared in other 2 cases but it was less than 2 mm. The mean of Harris hip score was （81.9 ± 14. 8）. The body weight index and the level of PBG were negatively correlated with the outcomes of Harris hip score. Conclusion Patients with type 2 diabetes mellitus may accept artificial joint replacement well, It is very important to mainrain the body weight and the level of PRG in a normal range after operation.