陶瓷-陶瓷全髋关节置换术治疗年龄<40岁患者的疗效观察

Outcomes of alumina-on-alumina total hip arthroplasty performed in patients younger than 40 years

目的探讨陶瓷-陶瓷全髋关节置换术（THA）治疗年龄〈40岁髋关节疾病患者的疗效。方法回顾性分析52例年龄〈40岁因髋关节疾病采用陶瓷-陶瓷THA治疗患者的临床资料。临床疗效评估重点观察手术前后Harris评分;影像学评估重点观察术后脱位率、骨溶解及陶瓷碎裂发生率等。结果 52例均获得随访,时间8~16（12.1±3.7）年。Harris评分由术前9~68（49.3±9.7）分提高到末次随访时68~98（95.1±6.7）分（P〈0.05）。除1例（1.9%）在术后7 d出现髋关节后脱位外,其余患者均无脱位。2例（3.8%）随访中出现关节异响,1例（1.9%）术后8年出现陶瓷碎裂。至末次随访,未出现假体松动及假体周围骨溶解。结论采用陶瓷-陶瓷THA治疗年龄〈40岁髋关节疾病患者可以获得满意的临床疗效。

Objective To investigate the outcomes of alumina-on-alumina total hip arthroplasty （THA） for the treat- ment of hip joint disease in patients younger than 40 years. Methods A retrospective analysis of 52 patients with hip disease and aged 〈 40 years were treated by THA using alumina-on-alumina bearings. Clinical outcomes were as- sessed according to Harris score. Postoperative radiographic assessment were focused on dislocation rate, presence of osteolysis and ceramic fracture. Results The mean follow-up time was （12. 1 _＋ 3.7） years （range, 8 to 16 years）. The average Harris hip score was significantly improved from （49.3 ＋9. 7） points （range, 9 to 68 points） by preop- eratively to （95.1 -＋ 6. 7 ） points （ range, 68 to 98 points） by the final follow-up （ P 〈 0. 05 ）. There was 1 patient （ 1.9 % ） with hip posterior dislocation on postoperative 7 days, the remaining patients had no dislocation. There were two hips （3.8%） with squeaking hips; there was one hip （1.9%） with ceramics fracture in postoperative 8 years. No osteolysis and prosthetic loosening was detected at the final follow-up. Conclusions Satisfactory clinical outcome of alumina-on-alumina bearings in THAs can be expected in patients younger than 40 years.