改良Gibson切口人工髋关节翻修术46例(48髋)随访分析

Follow-up analysis of revision hip replacement by revised Gibson incison

[目的]评价改良Gibson切口人工髋关节翻修术的临床效果。[方法]对1984年1月-2006年6月首次髋关节置换术后出现脱位、松动等原因产生疼痛和功能障碍行全髋关节翻修术者(revision of total hip replacement,RTHR),其中有完整资料并经至少2年以上随访的46例48髋进行分析。男14例,女32例,年龄39～76岁。初次行股骨头置换术9髋,其中骨水泥型2髋,生物型7髋;全髋关节置换(THR)39髋,其中骨水泥型29髋,生物型10髋。采用改良Gibson切口进行全髋翻修术。[结果]46例48髋术后通过门诊或登门随访,采用Harris评分标准进行评分,由术前的平均41.9分提高到术后的平均81.8分,对手术满意度的评价:非常满意16例,满意28例,不满意2例。[结论]采用改良Gibson切口行全髋翻修术,根据不同分型,采取不同的方法可获得满意的疗效。

[ Objective] To evaluate the clinical results of revision hip replacements by revised Gibson incision. [ Method] Analysis of revision operations of 48 hips in 46 patients was carried out in a minimum of 2 - year follow-up from January 1984 to June 2006. There were 14 males and 32 females ageing from 39 to 76 years. The primary operation included femoral head replacement in 9 （ cemented in 2, noncemented in 7 ） and total hip replacement in 39 hips （ cemented in 29 hips, noncemented in 10 hips）. All operations were performed by revised Gibson incision. [ Result] The follow-up was carried out by office visit or home visit. Harris scores improved from 41.9 points preoperatively to 81.8 points postoperatively. The satisfaction was graded as excellent in 16 ,good in 28 and poor in 2. [ Conclusion]The clinical results of revision hip replacement by revised Gibson incision for different types by different methods can achieve satisfactory effect.