全髋关节表面置换术的近期疗效观察

Observasion of the early clinical results of total hip surface arthroplasty

目的评价全髋关节表面置换术治疗髋关节疾病的近期疗效。方法回顾性分析2006年10月至2008年4月行全髋关节表面置换术患者38例45髋,男18例22髋,女20例23髋;年龄24～74岁,平均42.5岁。股骨头坏死28例31髋(Ficat分期均为Ⅱ～Ⅲ期),强直性脊柱炎髋关节病变7例11髋,髋臼发育不良继发骨关节炎2例2髋,创伤性髋关节炎1例1髋。患者均为首次接受髋关节手术治疗,均无严重心血管疾病,术前均存在严重髋关节疼痛与活动受限,且1年以上保守治疗无效。术前VAS评分6～10分,平均(8.21±1.25)分;术前Harris评分30～45分,平均(36±7.85)分。采用金属对金属表面髋假体(metal on metal surface arthroplasty,MMSA)进行治疗。结果随访时间6～25个月,平均14个月。随访期间无一例发生严重并发症。术后VAS评分改善至0～4分,平均(1.52±1.16)分,与术前相比差异有统计学意义(t=26.32,P<0.01)。术后Harris评分增至84～98分,平均(93±5.25)分,与术前相比差异有统计学意义(t=40.49,P<0.01)。其中优39髋,良6髋,优良率100%。结论全髋关节表面置换术治疗年轻患者和对运动要求较高的老年患者的近期疗效满意,术后髋关节疼痛和髋关节功能明显改善。

Objective To evaluate the early clinical results and the experience of surface arthroplasty of the hip. Methods Totally 38 patients （45 hips） with osteonecrosis, ankylosing spondylitis, osteoarthfitis, or hip dysplasia were treated with total hip surface arthroplasty [ 18 male （22 hips）, 20 female （23 hips） ; mean age： 42. 5 years; mean follow- up： 14 months 1. Harris scores system was adopted for the evaluation. Results No serious complications such as dislocation, femoral neck fracture, and infection were recorded in all patients. The average Harris score improved from 36 to 93.The outcome of 39 hips were excellent, 6 good, and none failed. Conclusion The total hip surface replacement is an effective solution for the young patient and the older patient with more requirement of motion. The early results are satisfactory.