Tri-Lock骨保留股骨柄在中青年THA术中的应用

Application of Tri-Lock bone preservation stem in THA for young and middle-aged patients

目的观察Tri-Lock骨保留股骨柄（Tri-Lock BPS柄）在中青年全髋关节置换（THA）术中应用的短期临床效果。方法自2011-03—2013-08,采用Tri-Lock BPS柄进行THA 19例（19髋）。取后外侧股骨大粗隆后缘切口,50°截断股骨颈,取出股骨头,修整股骨颈,使用髓腔锉股骨远端扩髓。扩臼至能完全容纳下臼杯,待彻底止血后置入人工臼杯。置入Tri-Lock标准头颈,应用C型臂X线机透视确定标准头颈试模位置、松紧度、活动度以及稳定性,取出试模后,安装陶瓷颈后复位。结果本组切口长度（9.3±1.5）cm,术中出血量（300.0±141.0）ml。19例均获得随访3～31（19.5±8.0）个月,术后无感染、下肢深静脉血栓、关节脱位、异位骨化、假体松动移位等并发症发生。末次随访时疼痛均解除,双下肢等长,无跛行,髋关节屈曲度70°～110°。术前髋关节功能Harris评分（58.4±18.6）分,末次随访时提高到（97.3±3.9）分,各分项及总分差异均有显著统计学意义（P〈0.01）。术前双侧股骨偏心距差值为（4.9±2.9）mm,术后为（2.0±1.7）mm,差异有显著统计学意义（t=3.76,P〈0.01）。结论 Tri-Lock BPS柄在中青年THA术中应用的短期临床效果满意。

Objective To evaluate the short-term clinical outcomes of total hip arthroplasty（THA） with Tri-Lock bone preservation stem（Tri-Lock BPS） in young and middle-aged patients. Methods Nineteen cases（19 hips） were treated with Tri-Lock BPS from March 2011 to August 2013. All operations were performed using a posterolateral approach. Femoral neck was resected at a 50 degree angle, and took out femoral head. The acetabular cup and Tri-Lock BPS was implanted after under-reaming the acetabulum and femur. The surgeon checked the position, tightness, activity and stability of the cup and Tri-Lock BPS before resetting. Results In this group, the length of incision was（9.3±1.5）cm and the amount of bleeding was（300.0±141.0）ml. All the 19 cases were followed up for 3-31（19.5±8.0）months without infection, thrombosis, joint dislocation and heterotopic ossification. In the latest follow-up, all patients were relieved of pain without lameness and the hip joint activity was about 70°-110°. The preoperative average Harris score was（58.4±18.6）points and the postoperative average score was（97.3±3.9）points. The preoperative average offset was（4.9 ±2.9）mm and the postoperative average offset was（2.0 ±1.7）mm.There was statistically significant difference between two groups（P 0.01）. Conclusion The short-term clinical outcome of THA with Tri-Lock BPS in young and middle-aged patients is satisfactory.