陶瓷对金属人工全髋关节置换术临床体会

Clinical Experience of Ceramic-on-metal Total Hip Arthroplasty

目的:探讨陶瓷对金属人工全髋关节置换术的早期疗效和临床体会。方法:2007年2月～2009年1月,采用陶瓷对金属人工全髋关节置换术治疗26例(31髋)髋关节疾患,男11例,女15例。年龄41～75岁,平均54.5岁。其中股骨头坏死14例17髋,髋关节骨关节炎4例5髋,新鲜股骨颈骨折(GardenⅣ型)3例3髋,先天性髋关节发育不良3例3髋,类风湿性关节炎2例3髋。结合手术前后患者髋关节X线检查、髋关节功能检查及Harris评分,对陶瓷对金属人工全髋关节的临床应用特点进行分析。结果:术后患者伤口均一期临床愈合,无早期并发症发生。26例(31髋)获随9～12个月,平均随访10.5个月,术后X线片显示关节假体位置正确,髋关节活动度大幅改善,Harris评分显著提高。结论:陶瓷对金属人工髋假体设计具有臼杯变形小、磨损率低、活动范围大、脱位发生率低等特点。其为治疗术后活动量要求较高的髋关节疾病如股骨头缺血性坏死、骨关节炎、股骨颈骨折、先天髋发育不良、类风湿关节炎患者提供了一种新的有价值的手术方式。

Objective：To explore the short-term result and clinical application of ceramic-on-metal total hip arthroplasty and evaluate its safety and efficacy.Methods：From February 2007 to January 2009,31 hips in 26 patients（11 males and 15 females,ranging in age from 41 to 75 years,with an average of 54.5 years）were treated with ceramic-on-metal total hip arthroplasty,including 14 case of osteonecrosis（ON）,4 cases of osteoarthritis（OA）,3 cases of fresh femoral neck fracture,3 cases of congenital hip dysplasia（CDH）,and 2 cases of rheumatoid arthritis（RA）.X-ray examination was done before and after the operation in all patients,meanwhile,hip function and Harris hip score were performed to evaluate the clinical effect.Results：All the incisions healed well and there were no complications.All patients obtained follow-up and the average time was 10.5 months（9~12 months）.X-ray examination showed thatthe positions of the prostheses were normal,and hip function was largely improved,with Harris score significantly increased.Conclusion：Ceramic-on-metal total hip arthroplasty has the characteristics of minimum deformation of acetabular cup,low wearing,large range of motion and few dislocations.It offers a new and valuable technique for treatment of ON,OA,femoral neck fracture,CHD and RA with the higher requirement of movement after the operation.