中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2010年
10期
940-944
,共5页
焦竞%程文俊%王俊文%勘武生
焦競%程文俊%王俊文%勘武生
초경%정문준%왕준문%감무생
关节成形术,置换,髋%假体和植入物%治疗结果
關節成形術,置換,髖%假體和植入物%治療結果
관절성형술,치환,관%가체화식입물%치료결과
Arthroplasty,replacement,hip%Prostheses and implants%Treatment outcome
目的 比较金属对金属(MOM)大直径全髋关节置换术后与金属对聚乙烯(MOP)全髋关节置换术后的近期疗效.方法 2007年6月至2008年12月采用髋关节后外侧入路对30例(30髋)进行MOM大直径全髋关节置换术(MOM组),男12例,女18例;平均年龄60.3岁;平均体质量指数23.7 kg/m2;术前Harris评分平均为(36±15)分.同期采用后外侧入路对30例(30髋)进行MOP全髋关节置换术(MOP组),男9例,女21例;平均年龄62.4岁;平均体质量指数23.4 kg/m2;术前Harris评分平均为(34±17)分.对两组患者的术后功能恢复及影像学进行比较.结果 术后随访12～18个月(平均14.4个月),两组患者均未发生感染、骨折脱位及神经损伤等并发症,MOP组有1例患者术后2个月形成深静脉血栓.术后1、3、6、12个月Harris评分MOM组平均分别为(86±3)、(90±3)、(95±4)、(92±4)分,MOP组平均分别为(78±4)、(84±3)、(90±4)、(92±4)分.术后1、3、6个月两组Harris评分比较差异均有统计学意义(P＜0.05).术后MOM组髋关节总活动范围平均为239.2°±21.9°,屈髋平均为135.4°±10.9°;MOP组髋关节总活动范围平均为190.1°±16.7°,屈髋平均为95.3°±11.3°,差异有统计学意义(P＜0.05).结论 MOM大直径全髋关节置换相比传统MOP全髋关节置换短期疗效好,其中远期疗效需进一步观察.
目的 比較金屬對金屬(MOM)大直徑全髖關節置換術後與金屬對聚乙烯(MOP)全髖關節置換術後的近期療效.方法 2007年6月至2008年12月採用髖關節後外側入路對30例(30髖)進行MOM大直徑全髖關節置換術(MOM組),男12例,女18例;平均年齡60.3歲;平均體質量指數23.7 kg/m2;術前Harris評分平均為(36±15)分.同期採用後外側入路對30例(30髖)進行MOP全髖關節置換術(MOP組),男9例,女21例;平均年齡62.4歲;平均體質量指數23.4 kg/m2;術前Harris評分平均為(34±17)分.對兩組患者的術後功能恢複及影像學進行比較.結果 術後隨訪12～18箇月(平均14.4箇月),兩組患者均未髮生感染、骨摺脫位及神經損傷等併髮癥,MOP組有1例患者術後2箇月形成深靜脈血栓.術後1、3、6、12箇月Harris評分MOM組平均分彆為(86±3)、(90±3)、(95±4)、(92±4)分,MOP組平均分彆為(78±4)、(84±3)、(90±4)、(92±4)分.術後1、3、6箇月兩組Harris評分比較差異均有統計學意義(P＜0.05).術後MOM組髖關節總活動範圍平均為239.2°±21.9°,屈髖平均為135.4°±10.9°;MOP組髖關節總活動範圍平均為190.1°±16.7°,屈髖平均為95.3°±11.3°,差異有統計學意義(P＜0.05).結論 MOM大直徑全髖關節置換相比傳統MOP全髖關節置換短期療效好,其中遠期療效需進一步觀察.
목적 비교금속대금속(MOM)대직경전관관절치환술후여금속대취을희(MOP)전관관절치환술후적근기료효.방법 2007년6월지2008년12월채용관관절후외측입로대30례(30관)진행MOM대직경전관관절치환술(MOM조),남12례,녀18례;평균년령60.3세;평균체질량지수23.7 kg/m2;술전Harris평분평균위(36±15)분.동기채용후외측입로대30례(30관)진행MOP전관관절치환술(MOP조),남9례,녀21례;평균년령62.4세;평균체질량지수23.4 kg/m2;술전Harris평분평균위(34±17)분.대량조환자적술후공능회복급영상학진행비교.결과 술후수방12～18개월(평균14.4개월),량조환자균미발생감염、골절탈위급신경손상등병발증,MOP조유1례환자술후2개월형성심정맥혈전.술후1、3、6、12개월Harris평분MOM조평균분별위(86±3)、(90±3)、(95±4)、(92±4)분,MOP조평균분별위(78±4)、(84±3)、(90±4)、(92±4)분.술후1、3、6개월량조Harris평분비교차이균유통계학의의(P＜0.05).술후MOM조관관절총활동범위평균위239.2°±21.9°,굴관평균위135.4°±10.9°;MOP조관관절총활동범위평균위190.1°±16.7°,굴관평균위95.3°±11.3°,차이유통계학의의(P＜0.05).결론 MOM대직경전관관절치환상비전통MOP전관관절치환단기료효호,기중원기료효수진일보관찰.
Objective To compare the short-term results of metal-on-metal (MOM) and metal-on-polyethylene (MOP) bearing surfaces in total hip replacement (THR). Methods Thirty cases, 12 males and 18 females, received MOM THR through a posterolateral surgical approach from June 2007 to December 2008. Their mean age was 60.3 years, mean body mass index (BMI) was 23.7 g/m2 and mean Harris score was 36 ± 15 preoperatively. For comparison, another 30 cases, 9 males and 21 females, received MOP THR through the same approach at the same period. Their mean age was 62.4 years, mean BMI was 23.4 kg/m2 and mean Harris score was 34 ± 17 preoperatively. The 2 groups were compared in terms of hip functional recovery and radiographic examination. Results All patients obtained an average follow-up of 14.4 months (range, 12 to 18 months) . No infection, fracture or neurovascular injury occurred in either group. There were one deep venous thrombosis and one dislocation in the MOP group. The average Harris scores at 1, 3, 6, 12 months postoperatively were respectively 78 ±4, 84 ±4, 90 ±3, 92 ±4 for the MOP group and 86 ± 3, 90 ± 3, 95 ± 4, 95 ± 3 for the MOM group. The differences between the 2 groups were significant at 1, 3, 6 months ( P ＜ 0.05) but insignificant at 12 months ( P ＞ 0.05). In the MOM group,the total range of hip motion averaged 239.2°± 21.9° and the hip inflexion averaged 135.4°± 10.9°. In the MOP group, the total range of hip motion averaged 190.1°± 16.7° and the hip inflexion averaged 95.3°± 11.3°. The differences between the 2 groups were significant ( P ＜ 0.05). Conclusion On a short-term basis, MOM THR may be better than MOP THR, but the medium and long-term results of MOM bearing surfaces still need further investigation.
