氧化铝复合陶瓷在全髋关节置换中的应用

Alumina matrix composite ceramic-on-ceramic bearings in total hip arthroplasty

目的为了改善假体的生存率,减少陶瓷部件相关的并发症,新一代氧化铝复合陶瓷开始应用于临床,文中分析氧化铝复合陶瓷对陶瓷全髋关节置换的早期临床疗效。方法自2009年4月至2011年8月应用第4代氧化铝复合陶瓷对陶瓷对50例(59髋)髋关节疾病患者行全髋关节置换术,应用Harris评分及X线检查进行疗效评定。结果获得有效随访43例(52髋),平均随访21.4个月(12～40个月)。Harris评分由术前平均(43.0±16.3)分(11～64分)提高到末次随访时平均(92.6±5.3)分(80～100分)。未发生陶瓷组件的碎裂及假体脱位,1髋(1.9%)出现异响,1例发生症状性血栓。结论氧化铝复合陶瓷对陶瓷界面的短期临床效果满意,大头颈陶瓷假体的使用减少了术后脱位率,关节稳定性良好。

Objective A new alumina matrix composite material was developed to improve implant longevity and reduce the risk of component-related complications. The aim of this study was evaluate to retrospectively the short-term clinical results of alumina matrix composite ceramic-on-ceramic bearings in total hip arthroplasty. Methods From April 2009 to August 2011, we performed 59 total hip arthroplasties on 50 patients using alumina matrix composite eeramic-on-eeramic bearings at our institution. The clinical re- suits were evaluated by Harris hip score and X-rays. All patients were evaluated clinically and radiographieally at follow-up. Results At the time of the latest follow-up, forty-three （52 hips） patients were available for follow-up. Patients had a mean follow-up of 21.4 months （ range, 12 - 40 years）. The mean preoperative Harris hip score improved from 43.0 ~ 16.3 （ range, 11 - 64 ） points to 92.6 ＋ 5.3 （ range, 80 - 100） points at latest follow-up. There was no ceramic fractures and dislocations ; one patient （ 1.9% ） reported squea- king, 1 patient developed symptoms of deep veinthrombosis. Conclusion The early clinical results of alumina matrix composite ce ramie-on-ceramic total hip arthroplasty are favorable. Large-diameter femoral head in alumina matrix composite ceramic-on-ceramic to- tal hip arthroplasty had good stability and few dislocations. But further follow-up is required before a definite judgement can be made regarding the mid-term to long-term results.