CAJ | 학술논문

目的探讨初次人工髋关节置换术后失败的原因及相关危险因素.方法回顾性分析1988年11月至2008年7月收治的327例人工髋关节初次翻修手术患者的病史、临床和影像学资料以及手术记录.结果以髋关节翻修术作为终止点,共分析327例行初次髋关节翻修术的患者资料,具体失败原因包括假体无菌性松动(226/327,69.1%)、感染(52/327,15.9%)、假体周围骨折(22/327,6.7%)、假体不稳定(17/327,5.2%)、假体柄断裂(5/327,1.5%)、髋臼内衬脱落(5/327,1.5%).结论假体无菌性松动和感染是初次髋关节置换失败的主要机制,手术适应证和假体选择不当以及外科理念及技术局限是造成失败的关键因素.
목적 탐토초차인공관관절치환술후실패적원인급상관위험인소.방법 회고성분석1988년11월지2008년7월수치적327례인공관관절초차번수수술환자적병사、림상화영상학자료이급수술기록.결과 이관관절번수술작위종지점,공분석327례행초차관관절번수술적환자자료,구체실패원인포괄가체무균성송동(226/327,69.1%)、감염(52/327,15.9%)、가체주위골절(22/327,6.7%)、가체불은정(17/327,5.2%)、가체병단렬(5/327,1.5%)、관구내츤탈락(5/327,1.5%).결론 가체무균성송동화감염시초차관관절치환실패적주요궤제,수술괄응증화가체선택불당이급외과이념급기술국한시조성실패적관건인소.
Objective To summarize the detailed failure mechanisms of revision hip arthroplasties and related risk factors. Methods From November 1988 to July 2008 revision of total hip arthroplasties was performed in 327 patients. The medical history, clinical and imaging material and operation records were investigated. Results Regarding revision as the end point of the study, the reasons for 327 revision arthroplasties were aseptic loosening in 226 hips (69.1%), infection in 52 hips (15.9%), periprosthetic fracture in 22 hips (6.7%), instability in 17 hips (5.2%), stem fracture in 5 hips (1.5%) and liner dissociation in 5 hips (1.5%). Conclusions The main failure mechanisms of primary hip arthroplasties are aseptic loosening and infection of implants, which could be attributed to improper selection of operation indications and implants and limitations to surgical philosophy and technique.