CAJ | 학술논문

目的研究人工全髋关节置换术后复发性脱位的外科处理方案和临床结果.方法回顾性研究了1997年3月至2010年11月因人工全髋关节置换术后复发性脱位而行人工髋关节翻修术并完成随访的12例患者资料.其中男性5例,女性7例；年龄20 ～ 73岁,平均52.7岁；体重指数14.8 ～30.0 kg/m2,平均23.6 kg/m2.随访统计患者Harris评分及WOMAC评分,并记录再脱位事件,深部感染,假体周围骨折,假体松动和肺栓塞等并发症情况,评价翻修手术的效果.结果患者随访时间1.0～12.7年,平均4.0年.所有患者在术后均未再发生脱位,无深部感染、肺栓塞、假体周围骨折和假体早期松动的并发症发生.患者末次随访时Harris评分平均为81±9,较术前的38±21明显提高,差异具有统计学意义(t=- 8.616,P＜0.05).患者随访时平均WOMAC评分为82±12,较术前的54±21明显提高,差异具有统计学意义(t=-6.200,P＜0.05).结论运用合理的翻修手术方案,可以使髋关节置换术后复发性脱位的患者获得满意的治疗效果.
목적 연구인공전관관절치환술후복발성탈위적외과처리방안화림상결과.방법 회고성연구료1997년3월지2010년11월인인공전관관절치환술후복발성탈위이행인공관관절번수술병완성수방적12례환자자료.기중남성5례,녀성7례；년령20 ～ 73세,평균52.7세；체중지수14.8 ～30.0 kg/m2,평균23.6 kg/m2.수방통계환자Harris평분급WOMAC평분,병기록재탈위사건,심부감염,가체주위골절,가체송동화폐전새등병발증정황,평개번수수술적효과.결과 환자수방시간1.0～12.7년,평균4.0년.소유환자재술후균미재발생탈위,무심부감염、폐전새、가체주위골절화가체조기송동적병발증발생.환자말차수방시Harris평분평균위81±9,교술전적38±21명현제고,차이구유통계학의의(t=- 8.616,P＜0.05).환자수방시평균WOMAC평분위82±12,교술전적54±21명현제고,차이구유통계학의의(t=-6.200,P＜0.05).결론 운용합리적번수수술방안,가이사관관절치환술후복발성탈위적환자획득만의적치료효과.
Objectives To study the surgical techniques and clinical outcomes of the revision surgery to treat recurrent dislocation after total hip arthroplasty.Methods From March 1997 to November 2010,12 patients ( 12 hips ) with revision total hip arthroplasty for recurrent dislocation were reviewed.There were 5 male and 7 female,aged from 20 to 73 years( mean age 52.7 years),whose body mass index (BMI) were 14.8-30.0 kg/m2 ( mean 23.6 kg/m2 ).The Harris score and WOMAC score were registed and analyzed before sugery and at the time of latest follow-up.Any episode of dislocation and other complications such as deep infection,deep vein thrombosis and pulmonary embolism (DVT-PE) events,periprothesis fracture,or early aseptic loosening were recorded.Results Twelve patients were successfully followed for 1.0-12.7 years ( mean 4.0 years).No further dislocation episodes reported and all the hips were stable at the time of follow-up.No one complicated as deep infection,DVT-PE events,periprothesis fracture,or early aseptic loosening.The Harris score was greatly improved from 38 ±21 before surgery to 81 ±9 at the time of last follow-up with statistic significance ( t =- 8.616,P ＜ 0.05 ) accompany with the WOMAC score elevation from 54 ±21 to 82 ± 12 significantly(t =-6.200,P ＜0.05).Conclusion With a reasonable algorithmic approach,the recurrent dislocated total hip arthroplasty can be treated with a relatively high success rate.