中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (22): 4053-4055.doi: 10.3969/j.issn.1673-8225.2010.22.015

• 骨科植入物 orthopedic implant • 上一篇    下一篇

三种人工髋关节置换治疗股骨头坏死67例：2年随访验证

赖笑雨，高  辉   

  1. 赣南医学院第一附属医院骨科，江西省赣州市 341000
  • 出版日期:2010-05-28 发布日期:2010-05-28
  • 作者简介:赖笑雨★，男，1983年生，江西省赣州市人，汉族，2008年南昌大学医学院毕业，硕士，医师，主要从事关节外科方面的研究。 562213821@qq.com

Three hip replacements for avascular necrosis of the femoral head in 67 patients: 2-year follow-up  

Lai Xiao-yu, Gao Hui   

  1. Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou  341000, Jiangxi Province, China
  • Online:2010-05-28 Published:2010-05-28
  • About author:Lai Xiao-yu★, Master, Physician, Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi Province, China 562213821@qq.com

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摘要：

背景：传统的全髋关节置换后可能需行多次翻修，近年来保留股骨颈甚至股骨头的人工髋关节置换的重建效果得到了普遍认可。
目的：采取保留股骨颈全髋置换、无柄关节以及表面置换方案治疗股骨头坏死，比较分析其治疗效果以及重建后并发症的发生情况。
方法：纳入2005-01/2007-07收治的股骨头坏死患者67例，根据病情分组治疗，保留股骨颈全髋置换组22例，无柄关节组20例，表面置换组25例，所有患者均获得2年以上随访。置换前、置换后1年及2年对患者进行评估，包括Harris髋关节评分、髋关节X射线片、髋关节与假体相关不良事件以及翻修情况。
结果与结论：经过2年以上的随访，表面置换组无翻修，Harris评分高于无柄关节组及保留股骨颈全髋置换组(P < 0.05)；无柄关节组翻修1例；保留股骨颈全髋置换组翻修2例。提示与保留股骨颈全髋置换及无柄关节置换相比，表面置换对于恢复患者髋关节功能有着明显的优势，并发症少，翻修率低，对于年轻患者是一个较好的选择。

关键词: 保留股骨颈全髋置换, 无柄关节置换, 表面置换, 股骨头坏死, 并发症

Abstract:

BACKGROUND: Traditional total hip replacement requires several revisions. The effect of reconstruction of femoral neck even femoral head by total hip replacement has been widely accepted.
OBJECTIVE: To compare the effect and complications of three hip replacements (collum femoris preserving, stemless hip prosthesis, and resurfacing arthroplasty) for avascular necrosis of the femoral head.
METHODS: A total of 67 cases of avascular necrosis of the femoral head were selected from January 2005 to July 2007. They were respectively treated with collum femoris preserving (n=22), stemless hip prosthesis (n=20), and resurfacing arthroplasty (n=25). All patients were followed up at least for 2 years. The patients were evaluated before, 1 and 2 years after surgery by Harris score, X-ray, hip and prosthesis-related bad events and revision.
RESULTS AND CONCLUSION: During the 2-year follow-up, no revision was performed in resurfacing arthroplasty group, and the Harris scores were significant greater than the other two groups (P < 0.05). One case was subjected to revision in stemless hip prosthesis, and 2 in collum femoris preserving. Results from the present study show that compared with collum femoris preserving and stemless hip prosthesis, resurfacing arthroplasty may be the more effective treatment for avascular necrosis of femoral head with less complications and lower rate of revision.

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