中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (15): 2347-2351.doi: 10.3969/j.issn.2095-4344.3809

• 人工假体 artificial prosthesis • 上一篇    下一篇

不同界面假体全髋关节置换治疗老年髋关节疾病的比较

刘蓬然1，焦  瑞2，陶  金2，陈  辉3，戴纪杭3，颜连启3   

  1. 1中南大学湘雅二医院，湖南省长沙市   410000；2扬州大学医学院，江苏省扬州市   225001；3江苏省苏北人民医院骨科，江苏省扬州市   225001
  • 收稿日期:2019-11-22 修回日期:2019-11-29 接受日期:2020-06-02 出版日期:2021-05-28 发布日期:2021-01-04
  • 通讯作者: 颜连启，主任医师，江苏省苏北人民医院骨科，江苏省扬州市 225001
  • 作者简介:刘蓬然，男，1994年生，山东省淄博市人，汉族，硕士，医师，主要从事骨科研究。
  • 基金资助:
    国家自然科学基金(81371971)，项目负责人：颜连启；国家自然科学基金(81772332)，项目参与者：陈辉、戴纪杭

Comparison of the effects of total hip arthroplasty with different interface prostheses in the treatment of elderly hip diseases

Liu Pengran1, Jiao Rui2, Tao Jin2, Chen Hui3, Dai Jihang3, Yan Lianqi3   

  1. 1Xiangya Second Hospital of Central South University, Changsha 410000, Hunan Province, China; 2Medical College of Yangzhou University, Yangzhou 225001, Jiangsu Province, China; 3Department of Orthopedics, Subei People’s Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China
  • Received:2019-11-22 Revised:2019-11-29 Accepted:2020-06-02 Online:2021-05-28 Published:2021-01-04
  • Contact: Yan Lianqi, Chief physician, Department of Orthopedics, Subei People’s Hospital of Jiangsu Province, Yangzhou 225001, Jiangsu Province, China
  • About author:Liu Pengran, Master, Physician, Xiangya Second Hospital of Central South University, Changsha 410000, Hunan Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 81371971 (to YLQ); the National Natural Science Foundation of China, No. 81772332 (to CH, DJH)

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摘要：

文题释义：
陶瓷面对陶瓷面髋关节假体：为新型髋关节假体，具有高生物组织相容性和优良的抗磨损性，使用寿命较长，但陶瓷材料脆性高，同时因工艺限制不具备假体后方3°-5°防脱位的高边，术后可能存在关节异响、假体破损、关节脱位等并发症。
陶瓷面对聚乙烯面髋关节假体：为新型髋关节假体，具备假体后方3°-5°防脱位的高边，术后关节异响、假体破损、关节脱位等并发症相对陶瓷面对陶瓷面髋关节假体较少，但抗磨损性较陶瓷面对陶瓷面髋关节假体弱。

背景：全髋关节置换为治疗股骨头坏死和股骨颈骨折等髋关节疾患的有效手段，术中假体界面材料选择是术后影响假体生存率最重要的因素。
目的：对比分析陶瓷面对陶瓷面和陶瓷面对聚乙烯面两种髋关节假体在中老年患者全髋关节置换后的疗效。
方法：选择2017年2月至2018年2月中江苏省苏北人民医院收治的60例股骨颈骨折和股骨头无菌性坏死疾病患者，年龄≥45岁，其中22例采用陶瓷面对陶瓷面假体行初次全髋关节置换治疗，38例采用陶瓷面对聚乙烯面假体行初次全髋关节置换治疗。术后1周及1，3，6，12个月，进行髋关节功能评分与并发症发生情况统计。试验获得江苏省苏北人民医院伦理委员会批准，批准号：2019112。
结果与结论：①两组术后不同时间点的髋关节功能评分比较差异无显著性意义(P > 0.05)；②陶瓷对陶瓷组出现2例关节异响，陶瓷对聚乙烯组出现1例周围神经损伤，两组关节异响、周围神经损伤发生率比较差异无显著性意义(P > 0.05)；③结果表明，陶瓷面对陶瓷面和陶瓷面对聚乙烯面2种假体均能在全髋关节置换后提供良好的疗效和髋关节功能重建，并且两者术后并发症发生率无明显差异。
https://orcid.org/0000-0003-4151-6014 (刘蓬然)

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 骨, 假体, 股骨头坏死, 股骨颈骨折, 全髋关节置换, 陶瓷, 聚乙烯, 人工髋关节假体, 骨科植入物, 术后疗效

Abstract: BACKGROUND: Total hip arthroplasty is an effective method for the treatment of hip joint diseases such as femoral head necrosis and femoral neck fracture. The choice of prosthetic interface materials during the operation is the most important factor affecting the survival rate of the prosthesis.   
OBJECTIVE: To compare the postoperative efficacy of ceramic on ceramic hip prosthesis and ceramic on polyethylene hip prosthesis in elderly patients of total hip arthroplasty. 
METHODS: Sixty patients with femoral neck fracture and aseptic necrosis of the femoral head, who were treated in the Subei People’s Hospital of Jiangsu Province from February 2017 to February 2018, aged ≥ 45 years old, were selected in this study. Among them, 22 were treated with ceramic on ceramic hip prosthesis and 38 were treated with the ceramic on polyethylene hip prosthesis. At 1 week, 1, 3, 6, and 12 months after surgery, hip joint function scores and complications were counted. The trial was approved by the Ethics Committee of Subei People’s Hospital of Jiangsu Province (approval No. 2019112).  
RESULTS AND CONCLUSION: (1) There was no significant difference in hip function scores between the two groups at different time points after surgery (P > 0.05). (2) There were two cases of joint noise in the ceramic on ceramic group and one case of peripheral nerve injury in the ceramic on polyethylene group. There was no significant difference in the incidence of joint noise and peripheral nerve injury between the two groups (P > 0.05). (3) The results showed that both the ceramic on ceramic and ceramic on polyethylene hip prosthesis can provide good curative effect and hip function reconstruction after total hip arthroplasty, and there was no significant difference in the incidence of postoperative complications between the two groups.  

Key words: bone, prosthesis, femoral head necrosis, femoral neck fracture, total hip arthroplasty, ceramics, polyethylene, artificial hip prosthesis, orthopedic implants, postoperative efficacy

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