CAJ | 학술논문

目的：回顾性分析初次骨水泥型全髋关节置换术（ THA）的中远期临床及影像学疗效、假体的生存率及其相关影响因素。方法对1991年7月至2006年6月间接受初次骨水泥型THA的患者187例（201髋）进行随访。观察并发症情况、影像学表现，并对Harris评分和骨密度结果值进行统计学分析，以假体翻修为随访终点，计算假体的生存率。结果共117例（126髋）获得完整随访，平均随访时间为13.5年。 Harris评分由术前的（32.8±22.5）分提高至末次随访时的（90.3±7.3）分，差异有统计学意义（ t＝－27.91， P＜0.01）。假体周围界面有不同表现的患者的骨密度结果比较无统计学差异（F＝0.289，P＞0.05）。晚期感染1髋，脱位3髋，下肢深静脉血栓4髋，下肢不等长4髋，假体周围骨折2髋，异位骨化6髋，无菌性松动5髋。共有7髋接受髋关节翻修手术，平均翻修手术时间为初次置换术后11.3年，假体的生存率为94.4％。结论骨水泥型THA在治疗高龄骨质疏松患者髋关节疾病方面可以取得良好的临床效果，骨水泥假体的远期生存率令人满意。
목적：회고성분석초차골수니형전관관절치환술（ THA）적중원기림상급영상학료효、가체적생존솔급기상관영향인소。방법대1991년7월지2006년6월간접수초차골수니형THA적환자187례（201관）진행수방。관찰병발증정황、영상학표현，병대Harris평분화골밀도결과치진행통계학분석，이가체번수위수방종점，계산가체적생존솔。결과공117례（126관）획득완정수방，평균수방시간위13.5년。 Harris평분유술전적（32.8±22.5）분제고지말차수방시적（90.3±7.3）분，차이유통계학의의（ t＝－27.91， P＜0.01）。가체주위계면유불동표현적환자적골밀도결과비교무통계학차이（F＝0.289，P＞0.05）。만기감염1관，탈위3관，하지심정맥혈전4관，하지불등장4관，가체주위골절2관，이위골화6관，무균성송동5관。공유7관접수관관절번수수술，평균번수수술시간위초차치환술후11.3년，가체적생존솔위94.4％。결론골수니형THA재치료고령골질소송환자관관절질병방면가이취득량호적림상효과，골수니가체적원기생존솔령인만의。
Objective To evaluate the mid-long term clinical and radiographic effects of the primary cemented total hip arthroplasty ( THA).Methods One hundred and eighty-seven patients (201 hips) who had undergone primary cemented THA from July 1991 to June 2006 were followed up for their post-operative complications and imaging findings .Harris score and bone density value were used for statistical analysis .The survival rate of the implants was determined by using the revision of either prosthetic component for any reason as the end-point during the follow-up.Results One hundred and seventeen patients (126 hips) were followed up for 13.5 years averagely in the end .Harris score improved significantly from (32.8 ±22.5) points to (90.3 ±7.3) points (t =-27.91,P <0.01).The bone density value had no significant difference among the different groups according to the different periprosthetic interface images (F=0.289, P>0.05).There was late infection in one hip, dislocation in three hips, DVT in four hips, inequality of lower limb in four hips , periprosthetic fracture in two hips , heterotopic ossification in six hips and aseptic loosening in five hips.Seven hips were revised after a mean time of 11.3 years.The survival rate of the implants was 94.4%.Conclusion The study suggests that the cemented THA may be suitable for treating all kinds of severe diseases of the hip joint for the senile osteoporosis patients and it can acheive good clinical outcomes .The cemented implant has satisfactory long-term results.