应用不同直径股骨头假体行全髋置换术后的近期疗效

The Short-term Effects of Femoral Head Prosthesises with Different Diameters after Total Hip Replacement

目的对不同直径股骨头假体行全髋置换术后的近期疗效进行对比研究。方法对2008年12月至2010年3月期间因股骨头坏死而接受全髋关节置换手术患者的术后疗效进行回顾性研究。患者共31例（Ficat-Arlet分期：Ⅲ-Ⅳ期,其中3例行髋关节表面置换）,其中大直径组（A组）14例19髋,小直径组（B组）17例17髋。平均随访时间为A组9.69个月,B组9.74个月。所有病例均进行Harris评分和影像学随访。结果术后Harris评分和髋关节屈伸活动范围2组比较差异有统计学意义。结论大直径股骨头可获得较好的近期Harris评分和关节活动度的改善,但其中、远期疗效仍需进一步随访。

Objective To compare the short-term effects of femoral head prosthesises with different diameters after total hip replacement.Methods A retrospective study was conducted in 31 patients with femoral head necrosis（Ficat-Arlet staging：Ⅲ~Ⅳ） who underwent total hip replacement surgery from December 2008 to March 2010（3 of them underwent hip surface replacement）.They were divided into 2 groups：the large diameter group（group A） and the small diameter group（group B）.There were 14 patients with 19 hips in group A,aged from 36 to 62 years old（50.2 years old on average）,and the average follow-up time is 9.69 months.There were 17 patients with 17 hips in group B,aged from 36 to 68 years old（55.6 years old on average）,and the average follow-up time is 9.74 months.Harris scoring and radiographic follow-up were conducted in all the patients.Results The differences in Harris scores and the ranges of flexion and extension were statistically significant between the two groups.Conclusion Higher Harris scores and short-term improvement of joint mobility can be obtained by large-diameter femoral head prosthesis after total hip replacement,but long-term follow-up is still necessary.