陶瓷对陶瓷全髋关节置换术的初步体会

Primary ceramic-on-ceramic total hip arthroplasty results:a minimal follow-up of 24 months

目的 回顾分析本组陶瓷对陶瓷全髋关节置换术的临床结果 ,探讨行全陶人工髋关节置换的手术体会.方法 本组在2000年3月～2008年4月间,对行陶瓷对陶瓷全髋关节置换术的患者进行随访,随访时间超过 24个月的有202例（269髋）,其中男123例（178髋）,女79例（91髋）,平均年龄46岁,随访时间平均41（24～122）个月.所有这些患者均进行了临床和影像学评估.结果 本组患者术前 Harris评分平均 53.47 （3～85）分 , 术后平均为90.66 （59～100）分.术后随访无患者有关节异响的主诉,未见假体松动,未发生假体周围感染,无翻修患者.无可观察到的磨损和骨溶解,无明显异位骨化.本组患者术中出现1例边缘崩裂.四种不同公司的髋臼对患术后Harris评分无显著影响.结论 本研究的短期随访结果 显示,现代陶瓷对陶瓷全髋关节置换术对于年轻的骨质量较好的患者是一种良好的选择,但需更长期的随访以验证其长期疗效.

Objective To report the clinical results of ceramic-on-ceramic total hip arthroplasty in a minimal follow-up of 24 months. Methods We retrospectively evaluated the clinical and radiological results of primary ceramic-on-ceramic total hip arthroplasty in 202 patients （ 269 hips） performed from March 2000 to April 2008. There were 123 male patients （178 hips） and 79 female patients （91 hips）. Their average age was forty-six years. The mean follow-up time was 41 （24 - 122） months. Results The average Harris score improved from 53.47 （ 3 - 85 ） points preoperatively to 90. 66 （ 59 - 100 ） points postoperatively. No patient demonstrated radiological loosening, osteolysis or heterotopic ossification. No prosthesis was revised or infected. Squeaking was not recorded in any hip. One ceramic liner was chipped intraoperatively. There was no significant difference among four types of ceramic cups. Conclusions Based on ourexperience, contemporary ceramic-on-ceramic total hip arthroplasty offers a promising choice for young, active patients. Longer follow-up time is required to demonstrate its long term results.