关键词: 全髋关节置换, 非骨水泥假体, 翻修, 并发症, 髋关节假体

Abstract:

BACKGROUND: With follow-up prolonged, more patients received total hip replacement need to revision. Periprosthetic osteolysi, accompanied by aspetic loosening, would be aggratate, which lead to artificial joint loosening, eventually, result in joint renovation.
OBJECTIVE: To observe the therapeutic effect of non-bone cement prosthesis on joint renovation following total hip replacement.
METHODS: Totally 41 patients (41 hips) received renovation following total hip replacement at the Shenyang Orthopaedics Hospital from 2004 to 2009 were selected. They were renovated by Circumflex type total hip joint and press fit type non-bone cement type total hip joints. Eight cases had acetabular deficiency, 17 cases had GustilloⅠ-Ⅱ acetabular loosening, and 8 cases had Gustillo Ⅲ acetabular loosening. All these patients were received spiral mortar shaping of pure titanium directly or combined with particle bone graft. Eight patients had Gustillo Ⅳacetabular loosening combined with bone defects, who adopted particles to plant the bone, rebuilt the hip mortar by titanium mesh, and shaping with bone cement. Non-bone cements prosthesis or lengthened prosthesis, as well as bone graft, was selected individualized. The cerclage band could be used if necessary.
RESULTS AND CONCLUSION: Eight patients received titanium mesh and bone graft could do un-bearing exercise, and the remained patients could perform bearing exercise at day 3 after renovation. In the 6-66 months follow-up, no prosthetic displacement or subsidence could be found. No patients need a second renovation. Harris scores were increased from 32.6 before operation to 88.1 after operation. X-ray film showed that the bone density was increased in parts of patients. The results demonstrated that hip renovation using non-bone cement prosthesis can received an excellent short-term therapeutic effect, but the long-term effect needs to be explored.