股骨头无菌性坏死半髋置换术后疗效分析

Effects of Aseptic Necrosis of the Femoral Head Treated with Hemi - arthroplasty

目的:评估半髋置换术治疗晚期股骨头无菌性坏死的疗效,并分析其原因。方法:分析1988～1996年72例(80髋)股骨头无菌性坏死患者行半髋置换术后随访5～13年(平均8.4年)的资料,对术前术后髋关节功能行Harris评分,评估临床疗效。分析术后X线资料,评估影像学变化与疗效间关系。对27例髋臼软骨作病理检查,观察晚期ANFH退变情况。结果:术前病髋Harris评分平均53分,最后1次随访时平均68分。12髋(15％)在随访的3～12年时施行了翻修术。最后1次随访时假体头端移位率为45％(36髋),假体柄松动率为37.5％(30髋)。送检的髋臼软骨均存在变性(100％)。结论:股骨头无菌性坏死行半髋置换术治疗的远期疗效不佳。

Objective: To analyze the results and its cause in aseptic necrosis of the femoral head treated with hemi -arthro-plasty. Methods: 72 cases (80 hips) with aseptic necrosis of the femoral head(ANFH) underwent hemi -arthroplasty. Palien ts information before and af ter operation were retrospectively studied. The clinical effects were evaluated by comparing preopera-tively Harris score with postoperatively score. The relation of clinical effects with radiological changes was evaluated. Degener-ation of cartilages of acetabulum was detected pathologically. Results; The average Harris hip score were 53 points preoperativ-ely. The score only were 68 at the end of the follow - up period. 12 hips(15% ) with unsatisfactory function were revised 3 -to- 12 year after original surgery. Radiologically, proximal migrations were seen in 36 hips(45%) and loosening of cementless femoral stems were seen in 30 hips(37.5% ) ai ihe end of the follovv - up period. Degeneration emerged in all specimens of car-tilages(100%).ConcIusion: The long-term results in ANFH treated with hemi - arlhroplasly was nol ideal.