中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (48): 8937-8940.doi: 10.3969/j.issn.1673-8225.2010.48.003

• 人工假体 artificial prosthesis • 上一篇    下一篇

生物型人工全髋关节置换治疗髋关节骨关节炎的中期疗效评估

陈  明1，郭承军2，黄和生3，舒  勇1，韩智敏1   

  1. 1南昌大学第一附属医院骨科，江西省南昌市    330006；2宜春市中医院骨科，江西省宜春市    336000；3南昌市洪都中医院创伤骨科，江西省南昌市    330006
  • 出版日期:2010-11-26 发布日期:2010-11-26
  • 作者简介:陈明☆，男，1972年生，江西省萍乡市人，汉族，2008年苏州大学毕业，博士，主要从事关节外科及创伤骨科研究。 chair.man88@yahoo.com.cn 并列第一作者：郭承军

Biotype total hip arthroplasty for hip osteoarthritis: Medium-term efficacy evaluation

Chen Ming1, Guo Cheng-jun2, Huang He-sheng3, Shu Yong1, Han Zhi-min1   

  1. 1 Department of Orthopedics, First Hospital of Nanchang University, Nanchang  330006, Jiangxi Province, China; 2 Department of Orthopedics, Yichun Hospital of Traditional Chinese Medicine, Yichun  336000, Jiangxi Province, China; 3 Department of Orthopaedics and Traumatology, Hongdu Hospital of Traditional Chinese Medicine, Nanchang  330006, Jiangxi Province, China
  • Online:2010-11-26 Published:2010-11-26
  • About author:Chen Ming☆, Doctor, Department of Orthopedics, First Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China chair.man88@yahoo.com.cn Chen Ming and Guo Cheng-jun equally contributed to this paper.

PDF

421

被引次数

33

摘要：

背景：目前关节置换技术的临床治疗效果不断提高，但应用时仍有很多困难需要解决。其中疗效评估，尤其是中期疗效缺乏长期随访及系统的评估标准。
目的：评估髋关节骨关节炎患者行生物型人工全髋关节置换后的中期疗效及影响因素。
方法：2001-07/2003-03采用生物型假体治疗35例髋关节骨关节炎患者，均采用改良Gibson切口，假体均为美国Stryker公司非骨水泥型人工全髋关节假体，进行5.3~8年的随访。临床评估以Harris评分为标准，影像评估根据置换后随访双髋关节正、侧位X射线片，观察臼杯、股骨假体位置及周围骨质改变，并测量臼杯内衬磨损速度与趋势；假体生存率采用Kaplan-Meier分析，分别以臼杯及股骨假体的无菌性松动和任何原因导致的翻修作为止点。
结果与结论：患者Harris评分从置换前的平均41分提高到最近随访时的平均91.3分。未出现可确诊的无菌性松动影像表现或要求翻修，亦未发现骨盆局限性骨溶解。聚乙烯内衬平均线性磨损率为(0.13±0.06) mm/年。Kaplan-Meier生存分析表明，臼杯及股骨假体的生存率均为100%。中期随访结果(至少5.3年)表明，生物型假体用于髋关节骨关节炎患者全髋关节置换术中，能够提供理想固定效果，临床疗效满意。未发现无菌性松动，骨溶解的发生率亦低下。但患者年龄越大，发生松动的概率越大，远期疗效需要进一步跟踪随访。

关键词: 全髋关节置换, 生物型假体, 骨关节炎, 中期疗效, 假体生存率

Abstract:

BACKGROUND: The clinical treatment effect of joint replacement has been improved. However, there are no follow up and evaluation standards of treatment effect.
OBJECTIVE: To assess the medium-term efficacy and impact factor of hip osteoarthritis cases following biotype artificial total hip arthroplasty.
METHODS: From July 2001 to March 2003, biological-based prosthetic treatment was used in 35 cases of hip osteoarthritis. All operation incisions were modified Gibson incision, cementless artificial total hip prosthesis was produced by Stryker U.S. companies. The cases were followed-up for 5.3-8 years. Harris score was used as the standard for clinical assessment, postoperative follow-up imaging was used as the standard assessment with anterior and posterior, lateral X-ray film of double hip joint to observe the acetabular cup, femoral prosthesis location and the surrounding bone change, the speed and trend of wear and tear of acetabular cup line. Prosthesis survival rate was analyzed using Kaplan-Meier analysis, acetabular cup and femoral aseptic loosening of prosthesis and renovation were detected respectively.
RESULTS AND CONCLUSION: Harris score was improved from average 41 points preoperatively to average 91.3 points at the recent follow-up. No case of aseptic loosening was diagnosed by imaging or required renovation, neither the limitations of pelvic osteolysis. The average linear polyethylene liner wear rate was (0.13 ± 0.06) mm per year. Kaplan-Meier survival analysis showed that the acetabular cup and femoral prosthesis survival rate was 100%. The medium-term follow-up (at least 5.3 years) showed that the biological-type prosthesis for hip osteoarthritis in patients with total hip replacement can provide an ideal fixed effects and satisfactory clinical efficacy. Aseptic loosening does not occur, and the incidence of osteolysis is low. However, the probability of occurrence of aseptic loosening increases with aging, and the long-term results require further follow-up.

中图分类号: