无柄人工髋关节置换治疗中青年股骨头坏死临床分析

Clinical analysis of young and mid-age patients with femoral head necrosis in non-stem hip replacement therapy

目的探讨无柄人工髋关节置换治疗中青年股骨头坏死的临床疗效。方法对采用无柄人工髋关节置换术治疗的16例中青年股骨头坏死住院患者的临床资料进行回顾性分析。采用硬膜外麻醉,作髋关节后外侧切口,按一心、二塑、三平、四罩的顺序进行操作,在合适的头颈处装上与试模相配的罩杯和小头,关节复位。结果无柄人工髋关节置换术治疗中青年股骨头坏死患者16例中,随访18～60个月,平均42个月。按Harris评分平均为95分;优12例,良3例,中等1例。优良率96%。结论无柄人工髋关节置换术适用于中青年股骨头缺血性坏死晚期患者,近期疗效好,能有效保存骨量,但远期效果有待长时间观察。

Objective To investigate the clinical effect of non-stem hip replacement therapy in treating young and mid-age patients.Methods The clinical data in 16 young and mid-age cases of femoral head necrosis were collected.This therapy employed epidural anesthesia,and the incision used dorsolateral technique by specific surgical procedures.The suitable model was installed in the right place of head and neck and the joint was reduced.Results 16 young and mid-age cases of femoral head necrosis were cured by non-stem hip replacement therapy,and followed up for 18-60 months（average 42 months）.According to Harris scoring system,the average score was 95,and 12 cases,3 cases and 1 case obtained excellent,good and favorable.96% was rated good to excellent.Conclusion Non-stem hip replacement is suitable for the young and mid-age patients with advanced femoral head ischemic necrosis.The short-term curative effect is obvious and the bone-conserving benefits well,but the long-term effects are still to be long time observation.