解剖型非骨水泥全髋人工关节置换术近中期疗效研究

SHORT-TERM FOLLOW-UP OF RIBBED ANATOMIC CEMENTLESS TOTAL HIP ARTHROPLASTY

目的探讨解剖型非骨水泥全髋人工关节置换术治疗髋关节疾病的近中期临床疗效。方法2001年1月-2005年6月，采用Ribbed解剖型非骨水泥全髋人工关节置换术治疗髋关节疾病34例（38髋）。年龄29～55岁，平均42．7岁。病程3～18年，平均5．2年。其中股骨颈骨折7例7髋，髋臼骨折后创伤性关节炎5例5髋，股骨头坏死15例16髋，强直性脊柱炎7例10髋。术后获随访的21例患者术前Harris评分25～57分，平均38．6分。结果21例（23髋）获随访8～61个月，平均35个月。术后Harris评分76～98分，平均92．3分，与术前比较差异有统计学意义（P〈0．05）；术后髋关节功能优良率达93．5％。其中4例出现轻微大腿疼痛，经休息或服用非甾体类止痛药物后缓解。随访时X线片未见假体松动和下沉，呈骨长人性稳定。结论应用Ribbed解剖型非骨水泥全髋人工关节置换术治疗髋关节疾病，近中期效果满意。

Objective To summarize the clinical outcome of the Ribbed anatomic cementless total hip arthroplasty （THA） in the treatment of hip-joint disease. Methods From January 2001 to June 2005, 34 patients（38 hips） with hip-joint disease were treated with Ribbed anatomic cementless THA. Their ages ranged from 29 to 55 years with an average age of 42.7 years. The disease course was from 3 to 18 years. Among these cases, there were 7 cases （7 hips） of femoral neck fracture, 5 cases （5 hips） of traumatic arthritis after fracture of acetabulum, 15 cases （16 hips） of necrosis of the femoral head and 7 cases（10 hips） of ankylosing spondylitis. Four patients were operated on both hip joints. The average Harris hip score was 38.6（25-57） before operation. Results Twenty-one patients（23 hips） were followed up 8-61 months with an average of 35 months. The Harris hip score was 76-98 after operation with an average of 92.3, showing significant difference when compared with that before operation（P〈0.05）. The excellent and good result was achieved in 93.5 % of patients. Radiographs showed no prosthetic osteolysis and no evidence of loosening. Pain in the thigh occurred in 4 patients,and it can be relieved by using non-steroid anti-inflammatory drug. Conclusion Ribbed anatomic cementless THA has good clinical and radiographic results in treating patients with hip-joint disease.