髋关节表面置换术的临床应用及疗效

Clinical application and efficacy of hip resurfacing arthroplasty

[目的]通过对髋关节表面置换术病例的随访及分析,探讨该术式的临床应用及疗效。[方法]自2004年1月～2009年1月之间32例患者32髋施行了金属对金属的髋关节表面置换手术,其中男12例,女20例,平均年龄44.8岁(19～65岁),平均体重指数(BMI)25.2(18.7～33.1),术前诊断为股骨头缺血性坏死13例,髋臼发育不良继发骨关节炎19例。手术所采用的表面置换系统的髋臼侧均为生物型固定,股骨侧均为骨水泥型固定且带有导向柄。术后平均随访56个月(37～75个月)。[结果]1例髋臼发育不良继发骨关节炎男性患者因术后1个月出现股骨颈骨折而改行全髋关节置换术,其余病例至随访结束尚无出现松动、翻修,患者Harris评分较术前有显著提高,髋关节功能恢复良好。[结论]金属对金属髋关节表面置换术具有良好的临床疗效,但必须严格选择手术适应证并规范手术技术。

[ Objective ] To investigate the clinical application and efficacy of hip resurfacing arthroplasty by following-up and analyzing of the hip resurfacing cases. [ Method ] Thirty-two patients with 32 hips were treated with metal on metal hip re- surfacing arthroplasty from Jan. 2004 to Jan. 2009. The study group consisted of twelve men and twenty women with the average age of 44.8 years （ range, 19 - 65 years） and the average BMI of 25.2 （ range, 18.7 - 33.1 ）. Thirteen patients were diagnozed as avascular necrosis of femoral head and nineteen patients were diagnozed as osteoarthritis secondary to developmental dysplasia of the hip. The hip resurfacing prosthesis system with cementless acetabular side and stemmed cement femoral side was used in op- eration. The mean follow-up were 56 months （ range, 37 - 75 months）. [ Result ] One male patient with osteoarthritis was per- formed with total hip arthroplasty because of fracture of femoral neck at 1 month post-operation, and the other cases had no loos- ening or revision of the prosthesis till the terminal point of follow-up. Harris score was improved significantly and the function of hip recovered well. [ Conclusion ] Metal on metal hip resurfacing arthroplasty has good clinical efficacy, and that is based on strict selection of patients and standardized operative technique.