中年患者生物型假体全髋置换178例：7年随访资料回顾分析(英文)

Retrospective research on the effect of cementless prosthesis in total hip replacement of 178 middle aged patients during 7-year follow-up

背景:中年患者全髋关节置换后的恢复及假体生存率问题一直以来是一个比较棘手的问题,因为此组患者置换后对关节活动度的要求较老年患者的更高。目的:回顾性分析生物型假体在中年患者全髋关节置换后是否能促进功能恢复,减少骨质疏松及磨损,延长假体寿命。方法:选择以骨水泥型和非骨水泥型假体行单侧全髋关节置换的中年患者,对该组患者分别于置换前、置换后6个月,1年,4年及7年的临床症状及影像学检查进行随访。以Harris髋关节评分及生存率评价全髋关节置换效果,以任何原因形成的松动或翻修时间为截尾时间。结果与结论:非骨水泥型假体置换后6个月,1年,4年及7年的Harris评分明显优于骨水泥型假体(P<0.05),7年生存率也高于骨水泥型假体(P<0.05)。结果证实非骨水泥型假体较骨水泥型假体更能促进中年患者置换后髋关节的功能恢复,减少并发症的发生。

BACKGROUND：Total hip replacement in middle-aged patients is challenging regarding restoration and survival,because these patients are more active than old patients.OBJECTIVE：To retrospectively investigate whether a cementless prosthesis could restore hip function,decrease osteolysis,wear,and enhance prosthesis survival in middle-aged patients.METHODS：Clinical and radiological evaluations of patients undergoing single-side total hip replacement with cement and cementless prosthesis were analyzed preoperatively as well as at 6 months,1,4 and 7 years postoperatively.The outcomes of total hip replacement were assessed using Harris hip scores and survival rate.End point was loosening or revision of the femoral component for any reason.RESULTS AND CONCLUSION：Cementless prosthesis had gained better Harris hip scores than that of cement prosthesis group at 6 months,1,4 and 7 years postoperatively（P 0.05）.The survival rate was greater in cementless prosthesis compared with cement prosthesis during 7-year follow-up（P 0.05）.Results have suggested that cementless prosthesis achieves high rate of functional restoration and a low rate of complications in middle-aged patients following total hip replacement.