锆铌合金股骨头在中青年全髋置换术中的近期疗效

Zirconium niobium alloy femoral head in young and middle-aged recent treatment of total hip replacement

目的研究锆铌合金股骨头在中青年全髋置换术中的可行性和近期疗效。方法自2008年5月~2014年1月我科采用锆铌合金股骨头治疗中青年股骨头坏死22例(22髋)。采用Harris髋关节评分和WOMAC骨关节炎指数量表对髋关节功能进行评估。根据X线片对股骨假体周围Gruen分区及髋臼假体周围各Delee分区的骨质情况进行记录及分析,判断是否存在骨溶解及假体松动。结果本组22例患者术后随访25~63个月,平均(38.3±5.3)个月。术前Harris髋关节评分:11~67分,平均(41.5±9.5)分。末次随访:83~99分;平均(93.8±5.7)分。Harris髋关节评分差异具有统计学意义(t=23.136,P<0.01)。术前WOMAC评分:58~91分,平均(75.3±6.8)分。末次随访:1~12分;平均(9.5±5.7)分。WOMAC评分差异具有统计学意义(t=19.163,P<0.01)。随访期间未出现感染、深静脉血栓、大腿疼痛、假体脱位、假体破碎、异响、骨溶解及假体松动。结论将锆铌合金股骨头应用在中青年全髋置换术,短期疗效令人满意,可以减少假体松动及周围骨吸收,但对于脱位风险较高及术中复位困难的患者应谨慎应用。

Objective To investigate the zirconium niobium alloy femoral head in young and middle-aged feasibility and the recent curative effect of total hip replacement.Methods Since May2008~Jan201422cases(22hip)youth with femoral head avascular necrosis were treated with zirconium niobium alloy in our hospital.The Harris hip score and WOMAC osteoarthritis index scale to evaluate the hipjoint function.According to the X ray film Gruen partition around the femoral prosthesis and the acetabulum prosthesis around each Delee bone for recording and analysis of partition,judge whetherthereisbonedissolveandprosthesisloosening.Results Allpatientswerefollowedupfor38.3士5.3months(range25～63)_The Harris score improved from41.5士9.5(range,11～67)preoperatively to93_8士5_7(83-99)at the time of final follow-up.There were significant differences in Harris score(t=23.478,P<0.01).The WOMAC index improved from75.3士6.8(range,58～91)preoperatively to9.5士5.7(range,1～12)at the time of final follow-up.There were significant differences in WOMAC Index(t=19.163,P<0.01).Infection,deep vein thrombosis,thigh pain,prosthesis dislocation,prosthesis crushing,sound,dissolution of bone and prosthesis loosening did not appear during the follow-up period.Conclusion The zirconium niobium alloy femoral head in young and middle-aged total hip replacement,short-term curative effect is satisfactory,can reduce the loose prosthesis and the surrounding bone resorption,but high risk for dislocation and difficult resetting patients should be careful to application.