骨保留型短柄假体行全髋关节置换手术早期疗效观察

Early Clinical Efficacy of Bone Preservation Short-stem Prosthesis in Total Hip Arthroplasty

目的：探讨骨保留型股骨短柄假体行全髋关节置换手术的近期疗效及临床体会。方法：自2013年1月~2015年3月,首次接受人工全髋关节置换术共30例患者（38髋）,年龄38~70岁,均采用后外侧入路。通过比较术前、术后髋关节Harris评分、骨性关节炎指数可视化量表（WOMAC）,评价手术疗效。结果：术后所有患者均获得随访,最少6月,最长33月,平均19.5月。术后髋关节疼痛均明显好转,随访期内无严重并发症发生。髋关节Harris评分：术前45.3±4.3,术后末次随访94.1±5.4。术后末次随访Harris评分较术前改善明显,差异有统计学意义（P〈0.05）,术后3~4个月所有患者可以全负重行走。1例术中股骨近端骨折,术后愈合良好,未留后遗症。所有病例未发现假体松动或感染。结论：骨保留型股骨短柄假体行全髋关节置换手术近期临床效果满意,无严重并发症。新型短柄假体设计符合人体解剖特征,骨量保留多,术后疗效好,为髋关节置换提供了一种新的选择。

Objective： To study the clinical efficacy and application value of bone preservation short-stem in total hip arthoplasty. Methods： From January 2013 to March 2015, 38 hips in 30 patients ranging in age from 38 to 70 years old, underwent the primary total hip arthroplasty were selected as objects, and all the cases were treated through posterior-lateral approach. The patients were assessed by Harris hip score and the osteoarthritis index （WOMAC）. Results： All the patients were followed up with an average time of 19.5 months. After surgery, hip pain was significantly improved, and no serious complications were recorded in all the cases. The Harris score was increased from preoperative 45.3 ± 4.3 to 94.1 ± 5.4 at the latest follow up. Postoperative last follow up Harris score was significantly improved（P〈0.05）. All patients achieved full weight bearing in 3 to 4 months after operation. One patient had an intra-operation proximal femoral fracture, and recovered without any sequelae. None of the hips showed any sign of loosening or infections. Conclusions： The bone preservation short-stem in total hip arthoplasty are very encouraging and no serious complications, and the design of new short stem is in line with human anatomical features, and has the advantages in rapid recovery of hip function and retains more bone mass. It offers a newly valuable technology for the total hip arthroplasty.