Tri-Lock骨保留型股骨柄假体的设计特征与临床应用

Design features and clinical application of Tri-Lock bone preservation stem prosthesis

背景:新一代Tri-Lock BPS型股骨柄假体在原有设计基础上得到进一步改进,目前尚少有报道总结其设计特征及手术技巧。目的:总结Tri-Lock BPS型股骨柄假体的设计特征及其在全髋关节置换中的应用。方法:选择Tri-Lock BPS柄行全髋关节置换的患者9例(10髋),其中股骨头坏死8例,创伤性关节炎1例。置换前后的髋关节功能和置换后股骨柄假体的生物学固定分别按Harris标准和Engh标准评定,置换后股骨柄假体的初始固定质量按Healy标准评定,分析透亮线、骨溶解的发生率,分别按Delee和Gruen分区描述髋臼和股骨侧的骨长入,按D’Antonio法测量股骨柄假体的下沉,股区痛则采用目测类比评分10分制评定。结果与结论:10髋置换后X射线片显示股骨柄假体的初始固定均符合优良标准。凡手术满3个月的患者,髋关节功能(Harris评分)均可恢复至平均92分(85～96分),无主诉存在股区痛,无X射线显示的假体松动征。结果证实,Tri-Lock BPS型假体设计更符合人体解剖特征,髋关节功能恢复快,骨量保留多等优点。

BACKGROUND： The new generation of Tri-Lock bone preservation stem （BPS） femoral stem prosthesis is further improved. But it＇s design features and surgical techniques are still rarely reported. OBJECTIVE： To summarize design features and clinical application of the Tri-Lock BPS in total hip arthroplasty （THA）. METHODS： Totally nine patients （10 hips） were treated with THA using Tri-Lock BPS. Eight patients were diagnosed preoperatively with femoral head necrosis, while the other one with osteoarthritis. The preoperative and postoperative hip functions and postoperative biological fixation of femoral stem prosthesis were evaluated by Harris and Engh score. Postoperative initial fixation quality of the femoral stem prosthesis was evaluated by Healy score. The incidence of radiolucent line and osteolysis was analyzed. Bone ingrowth of acetabulum and femoral side was described respectively by Delee and Gruen. Subsidence of the femoral stem prosthesis was measured by D＇Antonio. Femoral area pain was evaluated by 10-point visual analogue score. RESULTS AND CONCLUSION： X-ray of the ten hips showed that the femoral stem prosthesis was in line with good initial fixed standard. At 3 months after surgery, the mean postoperative Harris hip score was 92 （range 85 to 96）. No one had thigh pain. There was no prosthesis loosening. The results showed that the design of Tri-Lock BPS is more in line with characteristics of human anatomy, and has the advantages in rapid recovery of hip function and retains more bone mass.