陶瓷对聚乙烯和金属对聚乙烯在全髋关节置换术后磨损的随访研究

Follow-up study on polyethylene wear of ceramic on polyethylene and metal on polyethylene in total hip arthroplasty

目的对陶瓷对聚乙烯和金属对聚乙烯全髋关节置换术的远期界面磨损进行回顾性研究。方法 1995年3月至2002年8月实施的127例非骨水泥固定的全髋关节置换术患者进行随访研究。根据关节界面配伍不同分成两组,即陶瓷对聚乙烯组(CP组)和金属对聚乙烯组(MP组)。两组患者分别经过平均8.7年和9.1年的随访,对手术后和最近随访的标准髋关节正位X线片进行股骨头位移的测量,同时评估骨溶解的情况及Harris评分。结果 CP组在聚乙烯线性磨损及骨溶解方面明显优于MP组,Harris评分两组间差别无统计学意义。结论陶瓷股骨头对聚乙烯是目前全髋关节置换术中较为理想的关节界面选择。

Objective To carry out a retrospective study of the polyethylene wear of ceramic on polyethylene and metal on polyethylene in total hip arthroplasty. Methods From March 1995 to August 2002, 127 eases with non-cement total hip arthroplasty were selected and divided into two groups （ceramic on polyethylene, CP; metal on polyethylene, MP） according to the interface of the joint prosthesis. After the 8.7 years and 9. 1 years follow-up respectively, the translation of the femoral head components was measured on the normal hip joint X-ray obtained post-operation and at the last follow-up. The osteolysis was observed and the Harris score was recorded in the two groups. Results At the last follow-up, 85% of the eases in CP group got the liner wear of 0-1 mm range and 49% in MP group. Three cases in CP group got the liner wear of more than 2 mm and 11 cases in MP group. Ten regions in acetabular and 13 regions in femoral side developed osteolysis in CP group. Nineteen regions in acetabular and 42 regions in femoral side developed osteolysis in MP group. The difference between the CP and MP groups in osteolysis was signifieant （P 〈 0. 01 ）. The Harris score had no significant difference between the 2 groups （ P 〉 0. 05 ）. Conclusions Ceramic on polyethylene is a good choice for joint interface in total hip arthroplasty at present.