人工髋关节初次翻修术的临床研究

Primary revision cementless total hip replacement for failed hip arthroplasty

目的探讨人工关节置换术后假体松动的原因及翻修技术。方法自2001年5月至2006年5月对68例采用生物固定全髋关节翻修术，男47例，女21例。年龄35～77岁，平均56．7岁。翻修原因除1例感染性松动外，其余均为无菌性松动。结果52例患者获得随访，随访时间为5个月～5．2年，平均2．6年。Harris评分由术前的平均（26±16）分升高至术后平均（72±9）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。并发症为术中发生股骨骨折2例，无一例患者发生感染或髋关节脱位。结论生物固定股骨翻修假体能够极大地方便髋关节翻修术，近期x线和临床效果满意。

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 68 cases that were admitted from May 2001 to May 2006. There were 47 males and 21 females, with age ranging from 35 to 77 years （mean 56.7 years）. All cases were aseptic loosening but one infective loosening. Results Fifty - two cases were followed up for 5 months to 5.2 years （ average 2. 6 years）. Harris＇ score was （26 ± 16） points preoperatively and （72 ±9） points postoperatively. All cases remained 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.