骨质疏松患者初次应用VerSys Advocate骨水泥股骨柄的中远期稳定性评估

Assessment of mid-long term stability of primary used the VerSys Advocate cemented femoral stem in osteoporotic patients

目的评估VerSys Advocate骨水泥股骨柄用于初次行全髋关节置换术骨质疏松患者的中远期稳定性,分析影响其稳定性的因素。方法对2004年5月-2010年5月需要行初次全髋关节置换且合并骨质疏松的患者共182例（222髋）进行手术,术中均使用VerSys Advocate骨水泥股骨柄假体。出院后定期随访,内容包括并发症发生情况、影像学、Harris评分、双能X线骨密度测定,并进行假体Kaplan-Meier生存分析。结果118例患者（144髋）获得完整随访,随访时间2-10年（平均6.1年）,Harris评分由术前的（33.5±14.8）分提高至末次随访时的（84.3±15.2）分,差异有统计学意义（t=-26.53,P〈0.01）。假体-骨水泥界面表现不同的患者骨密度结果比较差异无统计学意义（F=0.146,P〉0.05）。术中股骨距劈裂骨折和转子间骨折各1髋,术后发生下肢深静脉血栓4例（5髋）,术后发生迟发性感染2髋,无菌性松动3髋。共有7髋接受髋关节翻修手术,假体生存率为96.5%。结论 VerSys Advocate骨水泥柄治疗骨质疏松患者的中远期疗效良好,骨质疏松患者无菌性松动发生率较低,该型假体中远期生存率令人满意。

Objective To assess the mid-long term stability of primary used VerSys Advocate cemented femoral stem in osteoporotic patients and analyze the factors affected the stability of implants. Method To finish the total hip arthplasty for 182（222 hips） osteoporotic patients from May 2004 to May 2010 who need to be accomplished and used the VerSys Advocate cemented femoral stem. Followed up regularly for their post-operative complications,radiologic information. Harris score and determination of bone density value were used for statistical analysis. Analyzed the survival rate for implants. Results A total of 118 patients（144 hips） were completely followed up for 2 to 10 years,6.1 on average. The mean preoperative Harris hip score of（33.5±14.8） points significantly improved to（84.3 ±15.2） points at the final follow-up. Femoral calcar cleavage fracture and intertrochanteric fracture occurred in 1 hip each other during the surgery. There was deep venous thrombosis（DVT） in 4 patients（5 hips）,late infection in 2hips,aseptic loosening in 3 hips.7 hips were accepted the revision surgery. The survival rate of the implants was96.5%. Conclusions The study indicated that the VerSys Advocate cemented femoral stem has a encouraging midlong term clinical results for osteoporotic patients,for whom the incidence of aseptic loosening was low and the midlong term survival rate was sufficient.