中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2008年
35期
6989-6992
,共4页
郑文忠%陈昆%刘爱刚%潘永太%尤瑞金%马国棣%黄令坚%黄春福%黄钿锋%王鸿泰%肖奕增
鄭文忠%陳昆%劉愛剛%潘永太%尤瑞金%馬國棣%黃令堅%黃春福%黃鈿鋒%王鴻泰%肖奕增
정문충%진곤%류애강%반영태%우서금%마국체%황령견%황춘복%황전봉%왕홍태%초혁증
全髋关节置换术%保留股骨颈%髋关节%骨关节病
全髖關節置換術%保留股骨頸%髖關節%骨關節病
전관관절치환술%보류고골경%관관절%골관절병
背景:传统的人工全髋关节置换切除股骨颈,严重影响股骨近端受力平衡,引起骨重建负平衡,容易发生骨吸收,导致假体松动和下沉.目的:观察保留股骨颈型人工髋关节置换后材料与宿主的生物相容性.设计、时间及地点:回顾性病例分析,2000-09/2006-12解放军第一八○医院骨科病例资料.对象:25例患者,男10例,女15例,年龄31-56岁,平均47岁.股骨头坏死致髋关节6992骨关节病12例(5例为双侧),股骨头坏死8例(2例股骨颈骨折愈合后股骨头坏死),髋臼发育不良股骨头坏死3例,股骨颈头下型骨折不愈合2例.病程2～10年,平均6年.方法:采朋改良髋关节后路切口,显露髋关节,于股骨头颈交界处切除股骨头,磨除髋臼软骨,安装人工髋臼.用特制扩髓器扩大股骨近端髓腔,安装人工股骨头,人工关节复位.主要观察指标:①假体与宿主的生物相容性.②髋关节功能恢复情况.结果:患者伤口均一期愈合.随访0.5～6年,患者髋关节活动良好,行走步态正常.X射线摄片示人工髋关节位置良好,假体无松动和下沉,股骨颈骨质良好.结论:由于保留股骨颈,人工髋关节置换换后假体符合股骨近端的生理顺应性,防止股骨近端骨质疏松引起假体松动和下沉.
揹景:傳統的人工全髖關節置換切除股骨頸,嚴重影響股骨近耑受力平衡,引起骨重建負平衡,容易髮生骨吸收,導緻假體鬆動和下沉.目的:觀察保留股骨頸型人工髖關節置換後材料與宿主的生物相容性.設計、時間及地點:迴顧性病例分析,2000-09/2006-12解放軍第一八○醫院骨科病例資料.對象:25例患者,男10例,女15例,年齡31-56歲,平均47歲.股骨頭壞死緻髖關節6992骨關節病12例(5例為雙側),股骨頭壞死8例(2例股骨頸骨摺愈閤後股骨頭壞死),髖臼髮育不良股骨頭壞死3例,股骨頸頭下型骨摺不愈閤2例.病程2～10年,平均6年.方法:採朋改良髖關節後路切口,顯露髖關節,于股骨頭頸交界處切除股骨頭,磨除髖臼軟骨,安裝人工髖臼.用特製擴髓器擴大股骨近耑髓腔,安裝人工股骨頭,人工關節複位.主要觀察指標:①假體與宿主的生物相容性.②髖關節功能恢複情況.結果:患者傷口均一期愈閤.隨訪0.5～6年,患者髖關節活動良好,行走步態正常.X射線攝片示人工髖關節位置良好,假體無鬆動和下沉,股骨頸骨質良好.結論:由于保留股骨頸,人工髖關節置換換後假體符閤股骨近耑的生理順應性,防止股骨近耑骨質疏鬆引起假體鬆動和下沉.
배경:전통적인공전관관절치환절제고골경,엄중영향고골근단수력평형,인기골중건부평형,용역발생골흡수,도치가체송동화하침.목적:관찰보류고골경형인공관관절치환후재료여숙주적생물상용성.설계、시간급지점:회고성병례분석,2000-09/2006-12해방군제일팔○의원골과병례자료.대상:25례환자,남10례,녀15례,년령31-56세,평균47세.고골두배사치관관절6992골관절병12례(5례위쌍측),고골두배사8례(2례고골경골절유합후고골두배사),관구발육불량고골두배사3례,고골경두하형골절불유합2례.병정2～10년,평균6년.방법:채붕개량관관절후로절구,현로관관절,우고골두경교계처절제고골두,마제관구연골,안장인공관구.용특제확수기확대고골근단수강,안장인공고골두,인공관절복위.주요관찰지표:①가체여숙주적생물상용성.②관관절공능회복정황.결과:환자상구균일기유합.수방0.5～6년,환자관관절활동량호,행주보태정상.X사선섭편시인공관관절위치량호,가체무송동화하침,고골경골질량호.결론:유우보류고골경,인공관관절치환환후가체부합고골근단적생리순응성,방지고골근단골질소송인기가체송동화하침.
BACKGROUND:Resection of femoral neck in the conventional total hip replacement greatly influences the equilibrium of forces jn the proximal fetour and causes disequilibrium of bone reconstruction,easily resulting in bone absorption,prosthesis loosening and dislocation.OBJECTIVE:To investigate the biocompatibility between materials and host in the total hip replacement with femoral neck preserved.DESIGN,TIME AND SETTING:A retrospective case analysis was performed in the Department of Orthopedics,the 180 Hospital of Chinese PLA between September 2000 and December 2006.PARTICIPANTS:Twenty-five patients.10 males,15 females,aged 47 years old(range 31-56 years old)were recruited for this study.Twelve patients suffered from femoral head necrosis-caused hip joint disease and osteoarthrosis(bilaterally affected in 5 patients),eight femoral head necrosis(femoral head necrosis subsequent to femoral neck fracture healing in 2 patients),three acetabular dysplasia necrosis of femoral head,and two infra-head femoral neck fracture nonunion.The course of disease averaged 6 years old ranging from 2-10 years.METHODS:Modified hip ioint posterior approach was used to expose the hip joint.Femoral head was resected from the femoral head-neck iuncture.Cartilago acetabularis was stripped and then artificial acetabulum was installed.Femoral proximal medullary cavity was expanded.Artificial femoral head was installed.Finally,all artificial joints were reduced.MAIN OUTCOME MEASURES:(1)Biocompatibility between prosthesis and host.(2)Function recovery of hip joint.RESULTS:All wounds were primarily healed.Patients were followed up for 0.5-6 years on average.Follow-up results demonstrated good hip joint motion and normal walking gait.X-ray showed well-positioned artificial hip joint,absence of prosthesis loosening and dislocation,as well as good femoral neck sclerotin.CONCLUSl0N:The preservation of femoral neck in total hip replacement is fit to the physiological compliance of proximal femar and prevents osteoporosis-induced prosthesis loosening and dislocation in the proximal femur.
