第一代骨水泥全髋置换术的远期疗效分析

Total Hip Replacement Operation by Using First-Generation Cementing Techniques An Average of 11-Year Follow-up Study

报道了第一代CTHR36例38髋的远期疗效。平均随访11年，功能优良15髋，尚可12髋，差11髋。股骨头假体：肯定松动12髋，很可能松动15髋和可能松动11髋。臼杯：肯定松动5髋，濒临松动7髋。总体修正手术率21％。表明第一代CTHR的远期疗效显著差于文献报道的第二代CTHR。作者认为这与前者的骨水泥固定质量和假体设计存在缺陷有关。

36 cases with 38 Hip joints underwent total hip replacement operation as per formed by the use of the first-generation cementing techniques. The immediate postoperative radiograph for the quality of cement-fixa tion revealed that grade B in 4 hips, grade C in 5 hips and grade D in 29 hips, and none belonged to grade A. At average 11-Year follow-up, clinical results were evaluated as excellent or good in 40%, fair in 32%, poor in 28%.X-ray film revealed that definite loosening of the femoral component was 32%, probable loosening was 40% and the possible loosening was 18%, and definite loosening of the acetabular cup component was 13%, the impending loosening was 18%. Of the poor 11 hips, revision operations were performed on 3 hips for the loosening of the femoral component, on 5 hips for the loosening of the cup component. The total revision rate is 21 %. This paper pointed out the disadvantage of the first-generation cementing techniques, prosthetic design, and the mechanism which would influence the long-term therapeutic results.