国产骨水泥型人工全髋关节置换术的远期疗效分析

Long-term Result of Domestic Comented Prosthesis in Total Hip Arthroplasty

目的了解国产骨水泥型人工全髋关节置换术的远期疗效。方法作者对１９８１年３月～１９９１年３月期间行人工全髋关节置换术的５２例（５２髋）患者进行随访，平均随访时间１０年（７～１６年）。结果Ｈａｒｒｉｓ评分优良以上２０髋（３８．５％），中等１５髋（２８．８％），较差１７髋（３２．７％）。随访１０年以内患者Ｈａｔｒｉｓ评分平均为６８．４分，１０年以上平均为７４．６分，两者差异无显著性意义（ｔ检验，Ｐ＞０．０５）。８２．６％的患者术髋无明显疼痛。Ｘ线片显示４２．３％的髋臼假体和２６．９％的假体柄出现松动，整个松动率为４８．０％。７．７％的髋关节发生异位骨化。髋臼假体和假体柄松动是主要的翻修原因。结论作者认为国产骨水泥型人工全髋关节置换术的远期疗效较为满意，无菌性松动是最主要的远期并发症。只要严格掌握手术适应证，改进假体和手术工具的设计，规范操作，就能进一步提高疗效。

Objective To describe the long-term result of the total hip arthroplasty(THA) using thedomestic cemented prosthesis. Methods 52 cases underwent THA from 1981 to1991 were reviewed with anaverage of ten years (7 - 16 years) follow-up. Results Based on Haeds hip score, 20 cases (38. 5% ) gotexcellent and good result, 15 cases (28. 8% ) got fair result, 17 cases (32. 7% ) got bad result. The patientswith follow-up less than 10 years got 68.4 Harris score and that with follow-up more than 10 years got 74. 6Harris score. There is no significant difference (t test, P > 0. 05). 82. 6% of the patients had little or nopain, 42. 3% of acetabular components and 26. 9% of femoral components had aseptic loosening. The totalloosening rate was 48. 0%. Heterotopic ossification was present in 7. 7% of 52 cases. Conclusions It isconsidered that the long-term results of the native cemented total hip prosthesis are encouraging. Asepticloosening of acetabular and femoral components is the most important complication, which is the main reason ofrevision. If the patient was selected carefully and the design of the prosthesis and the technique of the operation improved, the long-term results can also be better.