浙江临床医学
浙江臨床醫學
절강림상의학
ZHEJIANG CLINICAL MEDICAL JOURNAL
2014年
9期
1387-1388,1391
,共3页
关节成形术%置换%翻修%髋
關節成形術%置換%翻脩%髖
관절성형술%치환%번수%관
Arthroplasty%Replacement%Revision%Hip
目的:骨水泥和非骨水泥股骨假体在髋关节翻修术中临床应用。方法回顾2005年3月至2010年6月,23例以非骨水泥假体行人工髋关节翻修术患者,22例以骨水泥假体行人工髋关节翻修术患者。只纳入了股骨骨缺损PaproskyⅠ、Ⅱ型。临床结果评估Harris髋关节评分(HHS)和VAPS评分和大腿疼痛的发生率。同时评估并发症的发生率。影像学评估再次股骨柄下沉以及股骨柄稳定性。结果骨水泥组术后HSS的平均值为79.2(范围32~100),非骨水泥组术后HSS的平均值为83.9(范围61~100)。骨水泥组术后VAPS评分平均为0.7(范围0~4)、非骨水泥组术后VAPS平均值0.5(范围0~3)。术后大腿疼痛骨水泥组发生1例(4%),非骨水泥组发生1例(9%)。并发症骨水泥组发生4例(19%),非骨水泥组发生5例(22%)。假体再次下沉松动骨水泥组发生3例(14%),非骨水泥组发生2例(9%)。两组评估指标差异无统计学意义。结论在髋关节翻修术中,骨水泥股骨假体和非骨水泥股骨假体均适用于股骨骨缺损PaproskyⅠ、Ⅱ型。规范的骨水泥使用技术和匹配的假体选择是手术成功的重要因素。
目的:骨水泥和非骨水泥股骨假體在髖關節翻脩術中臨床應用。方法迴顧2005年3月至2010年6月,23例以非骨水泥假體行人工髖關節翻脩術患者,22例以骨水泥假體行人工髖關節翻脩術患者。隻納入瞭股骨骨缺損PaproskyⅠ、Ⅱ型。臨床結果評估Harris髖關節評分(HHS)和VAPS評分和大腿疼痛的髮生率。同時評估併髮癥的髮生率。影像學評估再次股骨柄下沉以及股骨柄穩定性。結果骨水泥組術後HSS的平均值為79.2(範圍32~100),非骨水泥組術後HSS的平均值為83.9(範圍61~100)。骨水泥組術後VAPS評分平均為0.7(範圍0~4)、非骨水泥組術後VAPS平均值0.5(範圍0~3)。術後大腿疼痛骨水泥組髮生1例(4%),非骨水泥組髮生1例(9%)。併髮癥骨水泥組髮生4例(19%),非骨水泥組髮生5例(22%)。假體再次下沉鬆動骨水泥組髮生3例(14%),非骨水泥組髮生2例(9%)。兩組評估指標差異無統計學意義。結論在髖關節翻脩術中,骨水泥股骨假體和非骨水泥股骨假體均適用于股骨骨缺損PaproskyⅠ、Ⅱ型。規範的骨水泥使用技術和匹配的假體選擇是手術成功的重要因素。
목적:골수니화비골수니고골가체재관관절번수술중림상응용。방법회고2005년3월지2010년6월,23례이비골수니가체행인공관관절번수술환자,22례이골수니가체행인공관관절번수술환자。지납입료고골골결손PaproskyⅠ、Ⅱ형。림상결과평고Harris관관절평분(HHS)화VAPS평분화대퇴동통적발생솔。동시평고병발증적발생솔。영상학평고재차고골병하침이급고골병은정성。결과골수니조술후HSS적평균치위79.2(범위32~100),비골수니조술후HSS적평균치위83.9(범위61~100)。골수니조술후VAPS평분평균위0.7(범위0~4)、비골수니조술후VAPS평균치0.5(범위0~3)。술후대퇴동통골수니조발생1례(4%),비골수니조발생1례(9%)。병발증골수니조발생4례(19%),비골수니조발생5례(22%)。가체재차하침송동골수니조발생3례(14%),비골수니조발생2례(9%)。량조평고지표차이무통계학의의。결론재관관절번수술중,골수니고골가체화비골수니고골가체균괄용우고골골결손PaproskyⅠ、Ⅱ형。규범적골수니사용기술화필배적가체선택시수술성공적중요인소。
Objective To explore the outcomes of cemented prostheses and cementless modular Prostheses in revision total hip arthroplasty.Methods We designed a retrospective cross-sectional study to compare outcomes of the two femoral implant designs. Between March 2005 and June 2010, 23patients underwent revision with the cementless modular stem and 22 patients with the cemented stem at our institution. Patients in the study were all paprosky type I or type II. The recorded and compared preoperative characteristics of the two patient cohorts included HHS, VAPS, mild thigh pain, complications rate and radiographs obtained preoperatively. ResultsAt the last follow-up, the mean postoperative HHS was 79.2 (range, 32-100) in the cemented stem group and 83.9 (range, 61-100) in the cementless modular stem group. The postoperative VAPS scores averaged 0.7 (range, 0-4) in the cemented group and 0.5 (range, 0-3) in the cementless group. Mild thigh pain occurred in 1 (4%) patients in the cemented group and 1 (9%) patient in the cementless group. Complications occurred in4(19%) patients in the cemented group and 5(22%) patient in the cementless group. the median stem subsidence occurred in3(14%) patients in the cemented group and 2(9%) patient in the cementless group. There was no significant statistics difference between two groups of evaluation index.Conclusion In revision total hip arthroplasty, cemented femoral prosthesis and uncemented prosthesis implants are suitable for femoral defect PaproskyⅠ,Ⅱ type. Standardizing the use of cement technology and matching prosthetic choice is an important factor in the success of surgery.