CAJ | 학술논문

目的：评价普通非骨水泥股骨假体用于人工全髋关节翻修术的临床效果。方法对我科2008年1月-2011年11月期间行普通非骨水泥柄髋关节翻修手术的18例患者进行影像学和临床疗效评价。其中男性10例，女性8例；患者年龄45~76岁，平均58岁。行髋关节翻修的原因：假体周围感染10例，无菌性松动8例。所有患者翻修手术前后均行Harris评分和髋关节X线正侧位检查。结果18例均获得随访，随访时间6~42个月，平均30个月。术前Harris评分平均为39(23~53)分，截止最近一次随访评分均数增加至92(84~96)分。所有患者均在术后2~3个月完全负重，原有的疼痛也得到缓解。仅1例术后3个月门诊随访时诉大腿外侧有不适至轻度疼痛，口服双氯芬酸钠双释放胶囊75 mg 1/d，两周后症状消失。最近一次随访时，所有股骨假体均获得良好的骨长入。无明显并发症。仅1例术后两周脱位，给予手法复位单侧髋关节“人”字形石膏固定6周，随访6个月，未再脱位。结论普通非骨水泥股骨柄是部分髋关节翻修术中股骨假体翻修的良好选择，近期临床表现和X线检查结果令人满意。
목적：평개보통비골수니고골가체용우인공전관관절번수술적림상효과。방법대아과2008년1월-2011년11월기간행보통비골수니병관관절번수수술적18례환자진행영상학화림상료효평개。기중남성10례，녀성8례；환자년령45~76세，평균58세。행관관절번수적원인：가체주위감염10례，무균성송동8례。소유환자번수수술전후균행Harris평분화관관절X선정측위검사。결과18례균획득수방，수방시간6~42개월，평균30개월。술전Harris평분평균위39(23~53)분，절지최근일차수방평분균수증가지92(84~96)분。소유환자균재술후2~3개월완전부중，원유적동통야득도완해。부1례술후3개월문진수방시소대퇴외측유불괄지경도동통，구복쌍록분산납쌍석방효낭75 mg 1/d，량주후증상소실。최근일차수방시，소유고골가체균획득량호적골장입。무명현병발증。부1례술후량주탈위，급여수법복위단측관관절“인”자형석고고정6주，수방6개월，미재탈위。결론보통비골수니고골병시부분관관절번수술중고골가체번수적량호선택，근기림상표현화X선검사결과령인만의。
Objective To assess the application of non-cement femoral stem prosthesis in total hip revision. Methods The clinical and radiographic outcomes in 18 patients (10 males and 8 females) aged 45-76 years (mean 58 years) after total hip revision with non-cement femoral prosthesis from January 2008 to November 2011 in our department were assessed. Ten patients underwent total hip revision due to infection of the prosthesis and 8 patients underwent total hip revision due to aseptic loosening of the prosthesis. The patients were scored according to the Harris scoring scale and their hip joint underwent anterioposterior and lateral X-ray examination before and after operation. Results The patients were followed up for 6-42 months (mean 30 months). The Harris score was 39 (23-53) before operation and was 92 (84-96) at the last follow-up. The patients could walk without crutch and their hip pain was alleviated 2-3 months after operation. Only one patient complained of uncomfortable feeling and mild pain in her lateral hip, which were dismissed after having 75 mg difene, once a day for two weeks. The femoral stem prosthesis grew into the hip at the last follow-up with no significant complication. Dislocation found in one patient 2 weeks after operation was fixed with cast for 6 weeks. The patient was followed up for 6 months, during which no dislocation occurred. Conclusion Non-cement femoral stem prosthesis is a good choice for total hip revision with satisfactory short-term clinical and radiographic outcomes.