中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (48): 8981-8984.doi: 10.3969/j.issn.1673-8225.2011.48.013

• 人工假体 artificial prosthesis • 上一篇    下一篇

金属对金属大直径髋关节假体置换5年：21例全部随访评价

韩亚芳   

  1. 河北省大城县第二医院，河北省大城县  065900
  • 收稿日期:2011-08-01 修回日期:2011-10-21 出版日期:2011-11-26 发布日期:2011-11-26
  • 作者简介:韩亚芳☆，博士，主要从事外科方面的研究。 cxg7866186@126.com

Metal-on-metal large diameter total hip prosthesis replacement for 5 years: 21 cases follow-up and evaluation

Han Ya-fang   

  1. Second Hospital of Dacheng County, Dacheng  065900, Hebei Province, China
  • Received:2011-08-01 Revised:2011-10-21 Online:2011-11-26 Published:2011-11-26
  • About author:Han Ya-fang☆, Doctor, Second Hospital of Dacheng County, Dacheng 065900, Hebei Province, China cxg7866186@126.com

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摘要：

背景：金属对金属全髋假体因其具有良好的活动度因而被广泛应用于人工全髋关节置换。
目的：探讨金属对金属大直径髋关节假体置换中期临床效果。
方法：选择2004-04/2005-06在河北省大城县第二医院骨科行金属对金属髋关节假体置换的21例中青年患者，均在腰硬联合麻醉下完成金属对金属大直径髋关节假体置换，由同一医生通过门诊复查、电话以及信函等方式进行随访，统计置换后5年患者患侧髋关节Harris关节评分、关节活动度和所发生的并发症。
结果与结论：5年随访时21髋的髋关节Harris评分平均(94.3±1.6)分，均达到优水平，患侧关节屈曲(111.2±14.3)°、外展(40.3±3.4)°、内收(23.5±2.4)°、外旋(54.8±3.7)°、内旋(20.9±2.1)°，且未发现关节脱位者，1髋出现轻度骨溶解(4.8%)，2髋出现植入物松动，2髋出现髋关节周围疼痛，且均发生在置换后6个月以后，持续超过5年以上。说明金属对金属大直径全髋关节置换后患者中期稳定性好，关节活动功能恢复效果佳，且疼痛发生率低，尤其是对于中青年患者，具有较好的临床应用价值。

关键词: 大直径, 金属对金属, 髋关节假体, 中远期, 效果, 医学植入物

Abstract:

BACKGROUND: Due to the excellent activity, metal-on-metal total hip prosthesis has been widely used in artificial total hip replacement.
OBJECTIVE: To investigate the medium and long term effect of metal-on-metal large diameter total hip replacement．
METHODS: From April 2004 to June 2005, 21 hips of middle-aged and young patients were underwent the metal-on-metal large diameter total hip replacement under combined spinal-epidural anesthesia, and followed-up by the same surgeon through outpatient reexamination, telephone, mail letter, and statistics ipsilateral hip Harris score, range of motion and the occurrence of complications at 5 years postoperative.
RESULTS AND CONCLUSION: The average Harris hip score is (94.3±1.6), the flexion angle was(111.2±14.3)°, abduction angle was (40.3±3.4)°,adduction angles was (23.5±2.4)°, external rotation angle was (54.8±3.7)°, Internal rotation angle was (20.9±2.1)°, no dislocation was observed, 1 hip showed mild osteolysis (4.8%), 2 hips appear implant loosening, 2 hips appear painful around the hip joint at 5 years follow-up postoperative. And all these complications appeared at the 6th month after replacement and maintained for 5 years. Metal-on-metal large diameter total hip replacement showed good medium-term stability and joint function recovery, and low pain incidence. Especially for young patients, it has good clinical application value.

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