全髋关节置换时压配联合髋臼杯螺钉固定效果的分析

Analysis of the outcomes of press-fit acetabular components with screws in total hip arthroplasty

目的:探讨不使用髋臼杯螺钉辅助固定的非骨水泥压配臼杯在人工全髋关节置换中的应用价值。方法:对2011年1月~2015年1月期间因髋关节疾病在我院行全髋关节置换术的符合入选标准的80例患者进行回顾性分析。其中37例患者采用单纯压配固定(press-fit group,PG),43例患者采用压配联合髋臼杯螺钉固定(press-fit with screws group,PSG)。详细记录并比较两组患者的手术时间、术中出血量、术后伤口引流量、术前及末次随访时的Harris评分;分析并比较两组患者假体周围骨溶解、假体松动情况。结果:单纯压配固定的患者手术时间、术中出血及术后引流量均小于髋臼杯螺钉辅助压配固定的患者(P<0.05)。末次随访时采用单纯压配固定的患者出现髋臼假体周围骨溶解现象少于采用压配联合髋臼杯螺钉固定,但差异无统计学意义(P>0.05)。两组患者末次随访时均未出现假体周围骨折,假体松动等。两组患者末次随访时Harris评分均提高(P<0.05),两组患者手术前及末次随访时Harris评分间差异无统计学意义(P>0.05)。结论:全髋关节置换术是治疗髋关节疾病的有效手段。对于初次行全髋关节置换的老年患者,采用单纯压配固定更有利。

Objective： To assess the clinical value of applying press-fit cementless acetabular cup fixation without screws to total hip arthroplasty. Methods： Retrospective analysis was performed in 80 cases of hip lesions treated with total hip replacement in our hospital between January of 2011 and 2015.Of the patients,37 received simple press-fit acetabular cup fixation without screws（ PG group）,and 43 treated with press-fit acetabular cup fixation with screws（ PSG group）. Operative time,intraoperative blood loss,volume of postoperative drainage,Harris hip score before and the final follow-up were documented and analyzed concerning the incidences of periprosthetic osteoleysis and loosening. Results： The operative time,intraoperative blood loss,postoperative drainage volume were significantly lower in PG group than in PSG gorup（ P〈 0. 05）. Patients in PG group had lower incidence of periprosthetic osteoleysis than those in PSG group by the final follow-up,yet the difference was insignificant（ P〉 0. 05）. Final follow-up showed no incidences of periprosthetic fracture and periprosthetie loosening,yet improved Harris hip scoring in the two groups（ P〈 0. 05）. However,the Harris hip scores remained no statistical difference before and after operation（ P〉 0. 05）. Conclusion： Total hip replacement is an effective option for hip lesion. Press-fit cementless acetabular cup fixation without screws is favorable to elderly patients receiving the first total hip arthroplasty.