中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9691-9696.doi: 10.3969/j.issn.2095-4344.2012.52.001

• 人工假体 artificial prosthesis •    下一篇

陶瓷-陶瓷与金属-聚乙烯全髋关节置换后的早期效果比较

杨礼庆，李 希，付 勤   

  1. 中国医科大学附属盛京医院脊柱关节骨科，辽宁省沈阳市 110004
  • 收稿日期:2012-05-27 修回日期:2012-06-20 出版日期:2012-12-23 发布日期:2012-12-23
  • 作者简介:杨礼庆☆，男，1970年生，山东省即墨县人，汉族，2006年中国医科大学毕业，博士，副教授，主要从事关节外科的基础和临床研究。 yliqing@163.com

Comparison of the early effect of ceramic-on-ceramic with metal-on-polyethylene total hip prosthesis replacement

Yang Li-qing, Li Xi, Fu Qin   

  1. Department of Spondyloarthropathy and Orthopedics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
  • Received:2012-05-27 Revised:2012-06-20 Online:2012-12-23 Published:2012-12-23
  • About author:Yang Li-qing☆, Doctor, Associate professor, Department of Spondyloarthropathy and Orthopedics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China yliqing@163.com

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509

被引次数

5

摘要：

背景：陶瓷关节因具有出色的耐磨损性，极高的硬度，良好的生物相容性，已经开始大量应用于临床。但陶瓷-陶瓷全髋关节和传统金属-聚乙烯全髋关节置换的比较研究国内外研究较少。
目的：对比观察陶瓷-陶瓷与传统金属-聚乙烯全髋关节假体置换治疗年轻患者髋关节疾病效果的差异。
方法：2007年10月至2010年9月行全髋关节置换42例44髋，其中20例22髋选用陶瓷-陶瓷人工关节，22例22髋选用传统的金属-聚乙烯人工关节。手术方法采用外侧入路，置换后给予常规抗凝治疗及相应功能锻炼。置换后患者进行定期临床与放射学随访，至少随访6个月。置换前及置换后6个月时测量2组患者关节活动度，并以Harris评分评价髋关节功能。
结果与结论：所有患者无脱位、松动、感染、下肢深静脉血栓等并发症发生。陶瓷-陶瓷关节组患者置换后Harris评分及髋关节活动度显著改善(P < 0.05)。2组患者置换后Harris评分及髋关节活动度差异无显著性意义(P > 0.05)。提示陶瓷-陶瓷关节置换后效果良好，近期随访效果满意，在改善患者症状及髋关节活动度方面与传统的金属-聚乙烯关节相当，但其优点和长期疗效还有待进一步观察。因其具有良好的耐磨性，是年轻全髋关节置换患者较为理想的关节界面选择。

关键词: 全髋关节置换, 年轻患者, 人工关节, 陶瓷-陶瓷, 金属-聚乙烯, Harris评分, 关节活动度, 功能锻炼, 耐磨性, 随访

Abstract:

BACKGROUND: Ceramic joint has been used in the clinic due to its excellent wear resistance, high hardness and good biocompatibility. But the comparative studies at home and abroad on ceramics-on-ceramic and traditional metal-on-polyethylene total hip arthroplasty are rare.
OBJECTIVE: To retrospectively observe the therapeutic effects of ceramics-on-ceramic and traditional metal-on-polyethylene total hip prosthesis replacement for the treatment of adult hip disease.
METHODS: In the period of October 2007–September 2010, a total of 42 patients (44 hips) received total hip arthroplasty, and 20 patients (22 hips) received ceramics-on-ceramic total hip prosthesis replacement, 22 patients (22 hips) received traditional metal-on-polyethylene total hip prosthesis replacement. All the surgical methods were the standard posterolateral approach, then given the routine postoperative anticoagulation treatment and the corresponding functional exercise. Regular postoperative clinical and radiographic follow-up was performed for at least six months. Range of motion was measured both before replacement and 6 months after replacement, and the hip joint function was evaluated according to Harris score.
RESULTS AND CONCLUSION: The clinical effects of all patients were good without dislocation, loosening, infection, deep venous thrombosis and other complications. The Harris scores and the range of motion of ceramics-on-ceramic group was significantly improved (P < 0.05). There was no significant difference of Harris scores and the range of motion between ceramics-on-ceramic group and traditional metal-on-polyethylene group (P > 0.05). The effect of ceramic-on-ceramic prosthesis is good and the results are satisfactory for short-term follow-up. There is no difference of improving symptoms and hip range of motion between ceramics-on-ceramic and metal-on-polyethylene total hip prosthesis. However, its advantages and the long-term efficacy remain to be further observed. Because of the wear resisting, ceramics-on-ceramic total hip prosthesis will be a good choice for the young patients undergoing hip replacement surgery.

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