中华解剖与临床杂志
中華解剖與臨床雜誌
중화해부여림상잡지
Chinese Journal of Anatomy and Clinics
2015年
3期
236-240
,共5页
王北岳%刘国印%周利武%计忠伟%郭亭%赵建宁
王北嶽%劉國印%週利武%計忠偉%郭亭%趙建寧
왕북악%류국인%주리무%계충위%곽정%조건저
关节成形术,置换,髋%假体植入%股骨%骨水泥成形术%再手术
關節成形術,置換,髖%假體植入%股骨%骨水泥成形術%再手術
관절성형술,치환,관%가체식입%고골%골수니성형술%재수술
Arthroplasty,replacement,hip%Prosthesis implantation%Femur%Cementoplasty%Reoperation
目的:探讨非骨水泥假体柄在髋关节股骨侧翻修中的应用。方法回顾性分析2008年5月—2013年8月108例全髋关节置换术后及假体周围感染术后股骨侧采用非骨水泥假体柄翻修患者的临床资料,记录术中骨折、截骨、股骨远端开窗、股骨假体力线情况,术后定期随访。采用Harris方法评估髋关节功能,视觉模拟评分( VAS)评估术前及术后髋关节疼痛程度,根据X线片判断假体稳定性、骨愈合及骨长入情况。结果对本组病例进行了0.5~5年随访,平均随访33.4个月;术后X线检查显示术后3~6个月可见骨长入,6个月以上骨愈合及长入情况良好;随访期间未出现感染迹象,下地行走良好,无假体脱位、骨折及假体松动发生。术前Harris评分为(48.76±13.17)分,疼痛VAS评分为4.00(3.00,6.00)分。末次随访时Harris评分为(87.11±6.69)分,VAS评分为0.00(0.00,1.00)分,与术前比较差异均有统计学意义(P值均<0.05)。结论非骨水泥假体柄股骨假体在髋关节的股骨侧翻修术中有一定优势,且对股骨近端部分缺损患者同样有良好疗效。
目的:探討非骨水泥假體柄在髖關節股骨側翻脩中的應用。方法迴顧性分析2008年5月—2013年8月108例全髖關節置換術後及假體週圍感染術後股骨側採用非骨水泥假體柄翻脩患者的臨床資料,記錄術中骨摺、截骨、股骨遠耑開窗、股骨假體力線情況,術後定期隨訪。採用Harris方法評估髖關節功能,視覺模擬評分( VAS)評估術前及術後髖關節疼痛程度,根據X線片判斷假體穩定性、骨愈閤及骨長入情況。結果對本組病例進行瞭0.5~5年隨訪,平均隨訪33.4箇月;術後X線檢查顯示術後3~6箇月可見骨長入,6箇月以上骨愈閤及長入情況良好;隨訪期間未齣現感染跡象,下地行走良好,無假體脫位、骨摺及假體鬆動髮生。術前Harris評分為(48.76±13.17)分,疼痛VAS評分為4.00(3.00,6.00)分。末次隨訪時Harris評分為(87.11±6.69)分,VAS評分為0.00(0.00,1.00)分,與術前比較差異均有統計學意義(P值均<0.05)。結論非骨水泥假體柄股骨假體在髖關節的股骨側翻脩術中有一定優勢,且對股骨近耑部分缺損患者同樣有良好療效。
목적:탐토비골수니가체병재관관절고골측번수중적응용。방법회고성분석2008년5월—2013년8월108례전관관절치환술후급가체주위감염술후고골측채용비골수니가체병번수환자적림상자료,기록술중골절、절골、고골원단개창、고골가체력선정황,술후정기수방。채용Harris방법평고관관절공능,시각모의평분( VAS)평고술전급술후관관절동통정도,근거X선편판단가체은정성、골유합급골장입정황。결과대본조병례진행료0.5~5년수방,평균수방33.4개월;술후X선검사현시술후3~6개월가견골장입,6개월이상골유합급장입정황량호;수방기간미출현감염적상,하지행주량호,무가체탈위、골절급가체송동발생。술전Harris평분위(48.76±13.17)분,동통VAS평분위4.00(3.00,6.00)분。말차수방시Harris평분위(87.11±6.69)분,VAS평분위0.00(0.00,1.00)분,여술전비교차이균유통계학의의(P치균<0.05)。결론비골수니가체병고골가체재관관절적고골측번수술중유일정우세,차대고골근단부분결손환자동양유량호료효。
Objective To discuss the application of non-cement femoral stem prosthesis in total hip revision. Methods A review of 108 patients with revision hip arthroplasties and periprothetic infection using long non-cement femoral stem was made from May 2008 to Aug. 2013. The records included intraoperative fractures, osteotomy, distal femural windows and femoral strength line. The hip function was assessed by using Harris score. The preoperative and postoperative hip pain was assessed by using Visual Analog Scale ( VAS ) . The stability of the prosthesis, bone healing and bone ingrowth were determined according to X-ray in postoperative regular follow-up. Results The patients were followed up with a mean period of 6 months to 5 years (mean 33. 4 months). Postoperative X-ray evaluation of the prosthesis was in place, bone ingrowth appeared in 3-6 months, bone healing and bone ingrowth was in good condition in six months or more, no signs of periprothetic infection were found, the patients walked well without prosthesis dislocation, fracture and prosthesis loosening. Preoperative Harris score was (48. 76 ± 13. 17), pain VAS was 4. 00(3. 00, 6. 00). At last time of follow-up, Harris score was (87. 11 ± 6. 69), VAS score was 0. 00 (0.00, 1. 00), There were significant differences compared with preoperative (all P values <0. 05). Conclusions Long non-cement femoral stem has certain advantages in femoral revision and good effect on patients who have defects in the proximal portion of the femur.