CAJ | 학술논문

背景:陶瓷关节因具有出色的耐磨损性,极高的硬度,良好的生物相容性,已经开始大量应用于临床.但陶瓷-陶瓷全髋关节和传统金属-聚乙烯全髋关节置换的比较研究国内外研究较少. 目的:对比观察陶瓷-陶瓷与传统金属-聚乙烯全髋关节假体置换治疗年轻患者髋关节疾病效果的差异. 方法:2007年10月至2010年9月行全髋关节置换42例44髋,其中20例22髋选用陶瓷-陶瓷人工关节,22例22髋选用传统的金属-聚乙烯人工关节.手术方法采用外侧入路,置换后给予常规抗凝治疗及相应功能锻炼.置换后患者进行定期临床与放射学随访,至少随访6个月.置换前及置换后6个月时测量2组患者关节活动度,并以Harris评分评价髋关节功能. 结果与结论:所有患者无脱位、松动、感染、下肢深静脉血栓等并发症发生.陶瓷-陶瓷关节组患者置换后 Harris评分及髋关节活动度显著改善(P<0.05).2组患者置换后Harris评分及髋关节活动度差异无显著性意义(P>0.05).提示陶瓷-陶瓷关节置换后效果良好,近期随访效果满意,在改善患者症状及髋关节活动度方面与传统的金属-聚乙烯关节相当,但其优点和长期疗效还有待进一步观察.因其具有良好的耐磨性,是年轻全髋关节置换患者较为理想的关节界面选择.
배경:도자관절인구유출색적내마손성,겁고적경도,량호적생물상용성,이경개시대량응용우림상.단도자-도자전관관절화전통금속-취을희전관관절치환적비교연구국내외연구교소. 목적:대비관찰도자-도자여전통금속-취을희전관관절가체치환치료년경환자관관절질병효과적차이. 방법:2007년10월지2010년9월행전관관절치환42례44관,기중20례22관선용도자-도자인공관절,22례22관선용전통적금속-취을희인공관절.수술방법채용외측입로,치환후급여상규항응치료급상응공능단련.치환후환자진행정기림상여방사학수방,지소수방6개월.치환전급치환후6개월시측량2조환자관절활동도,병이Harris평분평개관관절공능. 결과여결론:소유환자무탈위、송동、감염、하지심정맥혈전등병발증발생.도자-도자관절조환자치환후 Harris평분급관관절활동도현저개선(P<0.05).2조환자치환후Harris평분급관관절활동도차이무현저성의의(P>0.05).제시도자-도자관절치환후효과량호,근기수방효과만의,재개선환자증상급관관절활동도방면여전통적금속-취을희관절상당,단기우점화장기료효환유대진일보관찰.인기구유량호적내마성,시년경전관관절치환환자교위이상적관절계면선택.
BACKGROUND:Ceramic joint has been used in the clinic due to its excel ent wear resistance, high hardness and good biocompatibility. But the comparative studies at home and abroad on ceramics-on-ceramic and traditional metal-on-polyethylene total hip arthroplasty are rare. @@@@OBJECTIVE:To retrospectively observe the therapeutic effects of ceramics-on-ceramic and traditional metal-on-polyethylene total hip prosthesis replacement for the treatment of adult hip disease. @@@@METHODS:In the period of October 2007–September 2010, a total of 42 patients (44 hips) received total hip arthroplasty, and 20 patients (22 hips) received ceramics-on-ceramic total hip prosthesis replacement, 22 patients (22 hips) received traditional metal-on-polyethylene total hip prosthesis replacement. Al the surgical methods were the standard posterolateral approach, then given the routine postoperative anticoagulation treatment and the corresponding functional exercise. Regular postoperative clinical and radiographic fol ow-up was performed for at least six months. Range of motion was measured both before replacement and 6 months after replacement, and the hip joint function was evaluated according to Harris score. @@@@RESULTS AND CONCLUSION:The clinical effects of al patients were good without dislocation, loosening, infection, deep venous thrombosis and other complications. The Harris scores and the range of motion of ceramics-on-ceramic group was significantly improved (P<0.05). There was no significant difference of Harris scores and the range of motion between ceramics-on-ceramic group and traditional metal-on-polyethylene group (P>0.05). The effect of ceramic-on-ceramic prosthesis is good and the results are satisfactory for short-term fol ow-up. There is no difference of improving symptoms and hip range of motion between ceramics-on-ceramic and metal-on-polyethylene total hip prosthesis. However, its advantages and the long-term efficacy remain to be further observed. Because of the wear resisting, ceramics-on-ceramic total hip prosthesis wil be a good choice for the young patients undergoing hip replacement surgery.