CAJ | 학술논문

目的探讨应用C2锥形扁柄假体行生物学固定型全髋关节置换术(THA)的中期疗效. 方法回顾性分析2004年1月至2006年1月采用改良Harding入路C2锥形扁柄假体行生物学固定型THA的50例(55髋)患者资料,男21例(24髋),女29例(31髋)；年龄24～88岁,平均63.8岁.损伤或疾病类型:股骨颈骨折23例(23髋),股骨头坏死22例(25髋),骨性关节炎3例(5髋),类风湿关节炎2例(2髋).对术后及随访时的影像学资料进行分析,末次随访时采用髋关节Harris评分标准评定疗效. 结果 45例(50髋)患者术后获6～8年(平均7年)随访,5例死亡.末次随访时髋关节Harris评分从术前平均33分(26 ～53分)提高至95分(85 ～100分).43例(48髋)患者无大腿痛主诉,仅2例(2髋)从坐位站起时感到大腿轻度酸痛,大腿疼痛率为4.2％.术后1年内X线片显示假体下沉＜l.5mm者31髋,无假体下沉者19髋；术后2年内增生性骨反应见于Gruen 2、3、5、6、11区,吸收性骨反应见于Gruen 1、7区.末次随访时无一例出现股骨近端或髓内骨溶解、假体松动,按Engh标准评定:所有患者均获骨长入固定. 结论 C2锥形扁柄假体通过适当下沉能促进假体微孔涂层区的骨长入,其矩形设计能减少应力遮挡性骨吸收,用于生物学固定型THA的中期疗效满意.
목적 탐토응용C2추형편병가체행생물학고정형전관관절치환술(THA)적중기료효. 방법 회고성분석2004년1월지2006년1월채용개량Harding입로C2추형편병가체행생물학고정형THA적50례(55관)환자자료,남21례(24관),녀29례(31관)；년령24～88세,평균63.8세.손상혹질병류형:고골경골절23례(23관),고골두배사22례(25관),골성관절염3례(5관),류풍습관절염2례(2관).대술후급수방시적영상학자료진행분석,말차수방시채용관관절Harris평분표준평정료효. 결과 45례(50관)환자술후획6～8년(평균7년)수방,5례사망.말차수방시관관절Harris평분종술전평균33분(26 ～53분)제고지95분(85 ～100분).43례(48관)환자무대퇴통주소,부2례(2관)종좌위참기시감도대퇴경도산통,대퇴동통솔위4.2％.술후1년내X선편현시가체하침＜l.5mm자31관,무가체하침자19관；술후2년내증생성골반응견우Gruen 2、3、5、6、11구,흡수성골반응견우Gruen 1、7구.말차수방시무일례출현고골근단혹수내골용해、가체송동,안Engh표준평정:소유환자균획골장입고정. 결론 C2추형편병가체통과괄당하침능촉진가체미공도층구적골장입,기구형설계능감소응력차당성골흡수,용우생물학고정형THA적중기료효만의.
Objective To investigate the mid-term results of total hip arthroplasty (THA) with a C2 flat tapered stem.Methods From January 2004 to January 2006,50 patients underwent THA with a C2 flat tapered stem for 55 hips through improved Harding approach in the First Affiliated Hospital to Soochow University.There were 21 men (24 hips) and 29 women (31 hips),aged from 24 to 88 years (average,63.8 years).There were 23 femoral neck fractures (23 hips) and 22 cases of avascular necrosis of the femoral head (25 hips),3 cases of osteoarthritis (5 hips) and 2 cases of rheumatoid arthritis (2 hips).The postoperative X-ray imaging data were analyzed and the clinical efficacy was assessed at the last follow-up by Harris system.Results Forty-five patients (50 hips) obtained an average follow-up of 7 years (from 6 to 8 years).The average Harris score improved from the preoperative 33 points (from 26 to 53 points) to the 95 points (from 85 to 100 points) at the last follow-up.Forty-three patients presented no complain of thigh pain but only 2 complained of slight soreness upon rising up from a sitting position.The rate of thigh ache was 4.2％.The postoperative X-ray measurements one year postoperation showed prosthesis subsidence less than 1.5 mm in 31 hips.At 2 years postoperation,proliferative bone responses were seen in Gruen zones 2,3,5,6 and 11,and absorptive bone responses in Gruen zones 1 and 7.The last follow-up showed no proximal or intramedullary osteolysis or prosthesis loosening but bony fixation by the Engh criteria in all cases.Conclusion The C2 fiat tapered stem can result in fine mid-term clinical results in patients undergoing cementless THA,because it can promote bone ingrowth into the prosthetic microporous coating and its rectangular design can reduce stress shielding bone resorption.