全髋关节表面置换术的近期疗效观察

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并探讨其临床体会。[方法]回顾性分析2006年10月～2008年4月行全髋关节表面置换术患者68例81髋,男32例40髋,女36例41髋;年龄24～74岁,平均42.5岁。采用金属对金属表面髋假体(metal on metal surface arthroplasty,MMSA),随访6～25个月,平均14个月,进行髋关节Harris评分。[结果]本组病例随访期间无1例发生严重并发症。术后髋关节疼痛均明显好转,Harris评分由术前平均36分(30～45分)提高到术后平均93分(84～98分),其中优70髋,良11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,严格的临床适应证、完善的术前准备、精细的手术操作和对表面髋特性的清晰认识是全髋关节表面置换术成功的关键。

[ Objective ] To evaluate the early clinical results and the experience of surface arthroplasty of the hip. [ Meth- ods] A total of 68 patients （81 hips） with osteoneerosis, ankylosing spondylitis, osteoarthfitis, or hip dyplasia were treated with total hip surface arthroplasty. They were 32 male （40 hip） and 36 female （41 hips） , with a mean age of 42.5 years. The mean follow -up was 14 mouths. Harris score system was used for the evaluation. [ Results] No serious complications such as dislocation, femoral neck fracture, or infection were recorded in all patients. The average Harris score improved from 36 to 93. The outcome of 79 hips were excellent, 2 good, and none failed. [ Conclusion] The good to excellent results were 100%. The total hip surface replacement is an effective solution for young patiens and old ateletic patients. The early results are satisfactory.