早期国产生物型人工全髋关节置换术中远期疗效分析

Analysis of prosthetic efficacy in early Chinese biotype total hip arthroplasty

[目的]探讨应用早期国产生物型人工全髋关节置换术(total hip arthroplasty,THA)的中远期疗效。[方法]自1997年10月～2004年3月,46例49髋不同病因的髋关节病变行国产生物型THA。通过临床效果及影像学分析治疗效果。[结果]46例平均随访时间8.5年(5～11.5年)。Harris评分由术前38分(35～50分),提高到末次随访的82分(70～90分)。影像学检查发现假体松动9髋,其中单纯髋臼松动3髋,股骨假体松动4髋,髋臼及股骨假体均松动2髋;脱位3例5次,1例为术毕回房搬动时发生,另外2例各2次为院外不当活动所致,均闭合复位成功。出现异位骨化1例,Brooker分级1级;1例出现髋部疼痛、跛行,X线片显示假体无明显松动,但骨质疏松明显,经抗骨质疏松治疗后症状缓解。无感染病例。优良率为73.9%。[结论]早期国产髋关节假体解决了患者的髋关节病痛,价格较低,缓解了患者的经济压力。同时,早期国产生物型髋关节假体在设计、工艺及配套器械方面有待改进,降低松动率,提高远期疗效。

[Objective]To investigate the efficacy of early Chinese biotype total hip arthroplasty（THA） in clinical application.[Methods]From October 1997 to March 2004,THA was done in 46 patients（49 hips） with early Chinese biotype.The efficacy was evaluated according to the clinical score and X-ray photographs.[Results]Forty-six patients were followed up for 511.5 years（average 8.5 year）.The mean Harris hip score improved from 38（3550） points preoperatively to 82（7090） points at final follow-up.The imaging observation showed that prothesis loosening occurred in 9 cases.There were hip dislocation in 3 cases.One dislocation occurred on the way to the ward after operation,and the other 4 events occurred after the patients were discharged.Close reduction was all successful.There was 1 case of ectopic ossification,Brooker classification was GradeⅠ.One patient had hip pain and limping.The X-ray photographs showed that there was obvious osteoporosis,but no prothesis loosening occurred.No infection w...更多as found.The total good to excellent result was 73.9%.[Conclusion]The early Chinese biotype total hip arthroplasty can relieve the pain.However,the design and the moding parts of the domestic prosthesis need to be modified in order to improve the prosthetic efficacy.