初次全髋关节置换术后5年以上随访结果

Outcomes at a minimum of five years after primary total hip arthroplasty

目的对本组行初次全髋关节置换术（THA）5年以上的患者进行临床及影像学随访,探讨其疗效、并发症及其影响因素。方法对北京协和医院骨科2006年以前行THA并具有完整临床资料的248例（285髋）患者进行临床及影像学随访。截至末次随访时,174例（198髋）获得随访,随访率为70.2%,随访时间平均为7.6年（5.5~11.6年）。临床随访包括术前术后Harris评分及各种并发症。影像学评估包括双侧髋关节正位（或骨盆正位）、患髋侧位片,判断人工假体位置、假体周围骨质以及并发症情况。结果术前Harris评分平均为34.4分（0~86分）,末次随访时平均为88分（35~99分）,优良率为88.5%。术后假体总的生存率为97.1%。术后并发症包括跛行（9例）、异位骨化（8髋）、脱位（7例）、假体松动（2例）和感染（3例）等。结论本组病例整体疗效满意、假体生存期长,随访率偏低、病例数偏少,因此有待于进一步随访。

Objective To evaluate the cilinical and radiographic results after primary total hip arthroplasty（THA） for more than 5 years.Methods A series of 248 patients（285 hips） who had undergone primary THA before 2006 were involved in this study.198 hips in 174 patients（70.2%） were available.The mean time of follow-up was 7.6 years（5.5-11.6 years）.Clinical outcomes were evaluated by Harris score.Components migration,bone remodeling around the implant and complications were assessed according to the anteriorposterior and lateral X-ray of the hips.Results The average Harris score improved from 34.4 preoperative to 88 postoperative.The survival rate of acetabular and femoral components was 97.1%,taking infection or aseptic loosening as the endpoint.Postoperative complications included limp（nine patients）,ectopic ossification（eight hips）,dislocation（seven hips）,aseptic loosening（two hips） and infection（three hips）.Conclusions Patients in this group had satisfactory clinical and radiographic outcomes at a minimum follow-up time of five years,but a further follow-up is still necessary because of the low follow-up rate and insufficient cases.