人工髋关节置换术后翻修原因分析及疗效探究

Analysis of Refurbishing and Study on Curative Effect after the Artificial Hip Replacement

目的探究人工髋关节置换术后翻修原因及其疗效。方法选择该院自2016年1月—2017年5月收治的行人工髋关节置换术后翻修患者97例,回顾性分析其临床资料,总结翻修原因,并采用Harris评分系统评价翻修术后的疗效。结果人工髋关节置换术后翻修原因主要有无菌性松动、感染、脱位、假体周围骨折、假体折断;其中早期翻修50例,中期翻修23例,晚期翻修24例。术后患者Harris评分为(91.4±5.1)分,而术前患者Harris评分为(39.1±4.8)分,经翻修术后患者Harris评分明显提高,且恢复率为96.91%。结论人工髋关节置换术后翻修原因主要有无菌性松动、感染、脱位、假体周围骨折、假体折断等,该手术失败风险期主要集中在髋关节置换术后早期,医师应详细评估患者术前体征,全面掌握术后手术指征,严格把控选择假体及术后预防感染方面工作,在此基础上科学使用翻修术可有效补救髋关节置换术失败造成的影响。

Objective To study the refurbishing and study on curative effect after the artificial hip replacement. Meth- ods 97 cases of patients with refurbishing after the artificial hip replacement admitted and treated in our hospital from January 2016 to May 2017 were selected, and the clinical data were reviewed, and the refurbishing causes were sum- marized, and the curative effect after the refurbishing was systematically evaluated. Results The major refurbishing causes after the artificial hip replacement were aseptic loosening, infection, dislocation, periprosthetic fracture and pros- thesis fracture; including 50 cases with early refurbishing, 23 cases with middle refurbishing, and 24 cases with ad- vanced refurbishing, and the postoperative Hart＇is score before and after surgery was respectively （39.1±4.8）points and （91.4±5.1）points, and the Harris scores obviously increased, and the recovery rate was 96.91%. Conclusion The major refurbishing causes after the artificial hip replacement mainly include the aseptic loosening, infection, dislocation, periprosthetic fracture and prosthesis fracture, and the failure risk period is mainly concentrated in the early period af- ter the artificial hip replacement, and the doctors should evaluate the preoperative evaluation in detail, comprehensively master the postoperative signs, strictly control the selection of prosthesis and postoperative prevention and infection work, and the use of refurbishing on this basis can effectively supplement the effect imposed by the artificial hip re- placement.