CAJ | 학술논문

目的评估国产表面多孔解剖型全髋关节置换术的远期疗效.方法 1990年1月至1998年4月接受国产表面多孔解剖型全髋关节置换术的95例患者经电话核实、预约及直接去患者家中随访,同时在当地医院拍摄标准髋关节正侧位X线片.随访指标:依据Harris评分评价临床疗效,应用Gruen和DeLee & Chamley分区法对股骨柄和髋臼杯的正侧位X线影像进行分析.结果 50例失随访,16例死亡.29例(37髋)得到随访,随访时间11～17年,平均13.8年.随访时4例4髋已得到翻修,其余患者随访时Harris评分6～98分,平均70.3分;其中优7例10髋,良4例6髋,中5例7髋,差9例10髋,优良率48.5%.6髋(18.2%)需行翻修,主要原因为假体无菌性松动及移位.按照Harris评分标准,患者术髋无疼痛或轻度疼痛18例,中度以上疼痛6例(偶服比阿司匹林强的镇痛剂),病废1例(因疼痛被迫卧床,卧床也有剧痛).X线片显示股骨柄下沉9髋,平均下沉9.3mm;股骨柄周围出现透光带12髋;股骨柄周围骨溶解10髋;髋臼假体侧出现透光带13髋;假体多孔表面层有不同程度脱落2髋.结论 20世纪90年代应用的国产表面多孔解剖型全髋关节置换术可有效改善患者功能,但其远期疗效还有待进一步提高.假体无菌性松动是其最主要的远期并发症.
목적 평고국산표면다공해부형전관관절치환술적원기료효.방법 1990년1월지1998년4월접수국산표면다공해부형전관관절치환술적95례환자경전화핵실、예약급직접거환자가중수방,동시재당지의원박섭표준관관절정측위X선편.수방지표:의거Harris평분평개림상료효,응용Gruen화DeLee & Chamley분구법대고골병화관구배적정측위X선영상진행분석.결과 50례실수방,16례사망.29례(37관)득도수방,수방시간11～17년,평균13.8년.수방시4례4관이득도번수,기여환자수방시Harris평분6～98분,평균70.3분;기중우7례10관,량4례6관,중5례7관,차9례10관,우량솔48.5%.6관(18.2%)수행번수,주요원인위가체무균성송동급이위.안조Harris평분표준,환자술관무동통혹경도동통18례,중도이상동통6례(우복비아사필림강적진통제),병폐1례(인동통피박와상,와상야유극통).X선편현시고골병하침9관,평균하침9.3mm;고골병주위출현투광대12관;고골병주위골용해10관;관구가체측출현투광대13관;가체다공표면층유불동정도탈락2관.결론 20세기90년대응용적국산표면다공해부형전관관절치환술가유효개선환자공능,단기원기료효환유대진일보제고.가체무균성송동시기최주요적원기병발증.
Objective To evaluate the long-term results of total hip arthroplasty with Chinese porous coated anatomic prosthesis (11-17 years). Methods Ninty-five patients who received total hip arthroplasty with Chinese porous coated anatomic prosthesis in our center from January 1990 to April 1998 were followed up retrospectively. The clinical results analyzed with Harris hip score, and the roentgenographic results ana-lyzed with DeLee and Charnley methods, respectively. Results Of the 95 patients, 50 patients lost contact,and 16 patients died. The rest (14 males and 15 females, 37 hips) were reviewed with an average of 13.8 years follow-up. The mean Harris hip score was 70.3 (6-98). 48.5% of them were rated as excellent and good (16 hips), 30.3% of them rated as bad. 6 hips of them needed revision, mainly due to aseptic loosening. 18 cases of them considered that the pain disappeared or slight pain that didn't affect the function of the hip joints exists after the primary replacement. The roentgenogram showed that for the femoral components, 9 femoral stems were subsided by 9.3 mm on average, osteolysis occurred in 10 hips, radiolucency around the stem occurred in 12 hips, and for the acetabular components, radiolucency occurred in 13 hips, the porous coated layers shed in 2 hips. Conclusion The long-term results of total hip arthroplasty with Chinese porous coated anatomic prothesis done in our center during 1990 to 1999 are fair, and aseptic loosening is the main complication.