Corail羟基磷灰石全涂层股骨柄假体全髋关节置换治疗高龄股骨颈骨折的早期疗效

Short-term clinical outcome of total hip arthroplasty for elderly femoral neck fracture with entirely Corail hydroxyapatite-coated femoral prosthesis

目的:探讨采用Corail羟基磷灰石(Hydroxyapatite,HA)全涂层股骨柄假体行全髋关节置换术(Total hip arthroplasty,THA)治疗高龄股骨颈骨折的早期疗效。方法:回顾性分析了2007年1月～2008年6月采用Corail假体THA治疗21例高龄股骨颈骨折患者的病例资料,随访进行Harris评分、X线片及临床并发症评估。结果:所有患者均安全度过围手术期,平均手术时间(52.6±7.17)min,术中出血(217.9±37.7)ml,术后深静脉血栓、脂肪液化各2例,认知功能障碍5例,无深部感染或神经、血管损伤病例,股骨柄假体初始固定均为优或良。术后19例患者获得平均9.5个月的随访,无大腿痛、死亡及翻修病例,Harris评分从术前的平均(37.2±6.7)分提高到术后的(83.5±4.8)分,2例患者可见假体下沉但都小于2mm,未见股骨柄透亮线、骨溶解或松动,所有患者均获骨性固定。结论:采用CorailHA全涂层股骨柄假体行THA治疗高龄股骨颈骨折安全性高,早期疗效令人满意。

Objective：To evaluate the short-term results of total hip arthroplasty（THA）with entirely Corail hydroxyapatite（HA）-coated prosthesis in the treatment of femoral neck fractures in the elderly patients.Methods：A total of 21 cases of primary THA from Jan 2007 to Jun 2008 using Corail prosthesis in the treatment of the femoral neck fractures in elderly patients were reviewed.Their results were studied clinically and roentgen graphically to evaluate chiefly their Harris scores,complications and thigh pain.Results：All patients were in good condition during the operation.The mean operation time and average bleeding volume during operation was（52.6 ±7.17）min and（217.9±37.7）ml,respectively.Except 2 patients with deep venous thrombosis,2 patients with fat necrosis and 5 patients with cognitive impairment,there were no serious complications occurred.The postoperative X-ray films showed that the initial fixation was excellent or good in all the stems.A total of 19 cases were followed up for 9.5 months on average.No thigh pain was seen in these cases.Their mean Harris scores were improved from 37.2±6.7 preoperatively to 83.5±4.8 postoperatively.X-ray examination showed no radiolucent lines,osteolysis,or loosing of prosthesis.Subsidence of prosthesis was found in 2 cases,however,with a distance less than 2 mm.All the prostheses achieved bony stabilization according to the criteria proposed by Engh et al.Conclusion：The THA for elderly femoral neck fracture with Corail entirely HA-coated prosthesis has an excellent clinical and radiological short-term results and meanwhile is safe.