CAJ | 학술논문

目的：探讨保留股骨颈型全髋关节置换治疗髋关节疾病的临床疗效。方法对23例髋关节疾病患者采用Gibson切口行保留股骨颈型全髋关节置换术,在头下位置将股骨头截断,保留完整的股骨颈,并选择合适的外展角及前倾角植入假体。术前术后行Harris髋关节评分,随访时摄片了解假体的位置。结果23例均获随访,时间33~50个月。 Harris评分由术前37.7分±9.0分提高到末次随访时的90.4分±3.2分,差异有统计学意义(P<0.05)。3例出现双下肢不等长(长度差异<2 cm)；无感染及神经损伤,无脱位及肺栓塞形成；出现异位骨化Ⅰ级2例,Ⅱ级1例。结论保留股骨颈型全髋关节假体治疗髋关节疾病,保留了更多宿主骨质,利于再次假体翻修,临床疗效良好。
목적：탐토보류고골경형전관관절치환치료관관절질병적림상료효。방법대23례관관절질병환자채용Gibson절구행보류고골경형전관관절치환술,재두하위치장고골두절단,보류완정적고골경,병선택합괄적외전각급전경각식입가체。술전술후행Harris관관절평분,수방시섭편료해가체적위치。결과23례균획수방,시간33~50개월。 Harris평분유술전37.7분±9.0분제고도말차수방시적90.4분±3.2분,차이유통계학의의(P<0.05)。3례출현쌍하지불등장(장도차이<2 cm)；무감염급신경손상,무탈위급폐전새형성；출현이위골화Ⅰ급2례,Ⅱ급1례。결론보류고골경형전관관절가체치료관관절질병,보류료경다숙주골질,리우재차가체번수,림상료효량호。
Objective To evaluate the therapeutic outcome of total hip arthroplasty ( THA) with collum femoris pre-serving for hip joint disease. Methods A retrospective study of 23 patients who underwent THA with the neck pre-serving femoral stems were presented through Gibson approach. The femoral heads were removed and retained the in-tegrity of the femoral neck. Subsequently, the prosthesis was implanted at the appropriate abduction and anteversion angle. Preoperative and postoperative Harris hip scores were investigated, and stem migration was analyzed by X-ray film postoperatively. Results All patients were followed up, with the follow-up range of 33 ~50 months. Clinical outcome was excellent, with Harris hip score increasing from 37. 7 ± 9. 0 preoperatively to 90. 4 ± 3. 2 at the time of the latest follow-up, and the difference was statistically significant (P<0. 05). Three patients had leg length discrep-ancy, however, the difference were less than 2cm. During the follow-up period no complications, such as infection, nerve damage, dislocation of hip joints or pulmonary embolism occurred. Heterotopic ossification was detected in three cases ( two Brooker grade I and one grade II) . Conclusions THA with collum femoris preserving can retain more bone, be easier for revision, and has an excellent outcome.