Cementless total hip arthroplasty: comparison of unilateral and bilateral effects

doi:10.3969/j.issn.2095-4344.2015.26.001

Abstract

Abstract:

BACKGROUND: Bone cement has certain toxic effects on the human body. The probability of renovation is high after bone cement total hip arthroplasty. It is reported that the long-term effect of cementless total hip arthroplasty is apparently better than bone cement total hip arthroplasty, and can be renovated conveniently.
OBJECTIVE: To investigate the clinical effect of cementless total hip arthroplasty on hip joint disease, and to compare the difference between unilateral replacement and bilateral replacement.
METHODS: Clinical and follow-up data of 233 patients (280 hips), who were treated with cementless total hip arthroplasty in the Department of Orthopedics, Wuzhou Worker’s Hospital, Seventh Affiliated Hospital of Guangxi Medical University from July 2007 to December 2013, were retrospectively analyzed. According to the replacement program, they were divided into unilateral replacement group (n=186) and bilateral replacement group (n=47). Harris score of hip joint, visual analog scale score of thigh pain, the excellent and good rate of hip joint during final follow-up and complications were compared between the two groups before replacement, at 6,
12 and 24 months after replacement.
RESULTS AND CONCLUSION: No significant difference in Harris scores was detected before replacement, at 6, 12 and 24 months after replacement (P > 0.05). Harris score was significantly higher at 6, 12 and 24 months after replacement compared with that before replacement in both groups (P < 0.05). No significant difference in the excellent and good rate was detected in the unilateral replacement group (87%) and the bilateral replacement group (86%) (P > 0.05). No significant difference in the visual analog scale score was seen before replacement, at 6, 12 and 24 months after replacement (P > 0.05). Visual analog scale scores were significantly lower at 6, 12 and 24 months after replacement than that before replacement in the two groups (P < 0.05). There was no significant difference in the incidence of complications after replacement in patients of both groups (P > 0.05). These findings confirm that the effects of cementless total hip arthroplasty for hip joint disease are evident, can effectively restore hip joint function. No significant difference was detected between unilateral replacement and bilateral replacement. Strict replacement operation and matching of prosthesis and medullary cavity can effectively reduce thigh pain after replacement.

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

Key words: Arthroplasty, Replacement, Hip, Pain Measurement, Postoperative Complications

CLC Number:

R318

Jiang Jin-song, Zhou Shu-quan, Qin Kai-bing, Feng Li-mei, Li Chuan-jie, Liang Mu-hua, Chen Xue-fei. Cementless total hip arthroplasty: comparison of unilateral and bilateral effects [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(26): 4101-4106.

Figures/Tables 7

References

[1] 窦勇,周一新,褚亚明,等.非骨水泥股骨假体翻修时术中骨折的相关原因分析[J].中国矫形外科杂志,2012,20(19):1749-1753.
[2] 连奎,戚超,于腾,等.骨水泥与非骨水泥型人工全髋关节置换治疗肾移植术后股骨头缺血性坏死的近期疗效比较[J].中国修复重建外科杂志,2013,27(12):1409-1413.
[3] 赵洪普,徐秋玉,吕玉明,等.骨水泥型与非骨水泥型双动人工股骨头治疗老年股骨颈骨折的对比研究[J].中国矫形外科杂志,2012, 20(12):1099-1101.
[4] 高玉镭,田敏,王东辰,等.骨水泥和非骨水泥型人工股骨双动头置换的临床疗效分析[J].中国矫形外科杂志,2013,21(6):571-574.
[5] 王远政,田晓滨,李波,等.50岁以下患者非骨水泥全髋关节置换5-7年随访结果分析[J].现代预防医学,2012,39(21):5756-5759.
[6] 陈建常,欧勇.非骨水泥型人工全髋关节置换术后两种引流方式的比较[J].中国矫形外科杂志,2013,21(14):1397-1401.
[7] 刘勇,张秀丽,张福江.应用非骨水泥型假体进行全髋关节置换术治疗类风湿性关节炎的早期并发症研究[J].中国全科医学,2013, 16(36):3607-3610.
[8] 万永鲜,卓乃强,鲁晓波,等.非骨水泥型全髋关节置换治疗强直性脊椎炎髋部病变近期疗效观察[J].重庆医学,2013,42(4): 434- 435.
[9] Amstutuz HC,Le Duff MJ.Hip results for osteonecrosis are as good as for other etiologies at 2 to 12 years. Clin Orthop Relat Res. 2010;468(2):375-381.
[10] 许超,孙鹏飞,郭永园,等.一期翻修并植骨治疗THR术后感染伴髋臼骨缺损30例临床分析[J].中国实用外科杂志,2014,34(S1): 47-48.
[11] 黄文泽,彭昊,方洪松,等.大头陶瓷-陶瓷人工全髋关节置换术治疗成人先天性髋关节发育不良[J].临床骨科杂志, 2013,16(02): 151-154.
[12] 袁宏,陆琳松,钟惠琴,等.唑来膦酸对骨质疏松患者全髋关节置换术后假体周围骨密度的影响[J].中华关节外科杂志(电子版), 2014,1(3):278-285.
[13] 朱书涛,刘洋,张明辉,等.内固定物与人工半髋关节置换治疗高龄不稳定股骨粗隆间骨折的疗效分析[J].中国矫形外科杂志,2012, 20(14):1272-1274.
[14] 赵红莲,刘晓丽,冯向春,等. 全髋关节置换术和半髋关节置换术治疗老年股骨颈骨折的疗效比较[J].中国老年学杂志,2014, 34(23):6671-6672.
[15] 吴连国,刘康,黄俊俊,等.强骨饮对股骨颈骨折患者人工股骨头置换术后假体周围骨密度的影响[J].中医正骨,2014,1(4):15-18.
[16] Digas G, Krrholm J, Thanner J. Different loss of BMD using uncemented press-fit and whole polyethylene cups fixed with cement: repeated DXA studies in 96 hips randomized to 3 types of fixation. Acta orthopaedica. 2006;77(2):218-226.
[17] 周定,臧谋圣,胡勇,等.骨水泥与非骨水泥股骨柄在初次全髋关节置换术后疗效的Meta分析[J].中华关节外科杂志(电子版),2014, 8(5):635-642.
[18] 屈瑾,雷新玮,展影,等.髋关节表面置换术假体柄固定方式对股骨近端骨密度及应力影响[J].中华医学杂志,2014,94(35): 2769- 2771.
[19] 杜正根. 骨水泥和非骨水泥型人工双动股骨头置换疗效分析[J]. 中国医学工程,2014,22(11):29-30.
[20] Chung LH, Wu PK, Chen CF, et al. Extensively porous-coated stems for femoral revision：reliable choice for stem revision in Paprosky femoral type III defects. Orthopedics. 2012; 35(7): 1017-1021.
[21] 吴玉仙,赛佳明,李玉椿,等. Ribbed非骨水泥股骨假体在人工全髋关节置换术中的近中期随访观察[J].中国骨与关节损伤杂志, 2014,29(S1):23-24.
[22] 陈跃平,陈亮,高辉,等.骨水泥与非骨水泥型全膝关节假体置换效果的系统评价[J].中国组织工程研究,2013,17(17):3132-3139.
[23] 陈建常,欧勇.非骨水泥型人工全髋关节置换术后两种引流方式的比较[J].中国矫形外科杂志, 2013,21(14):1397-1401.
[24] Callaghan JJ,Liu SS.Cementless tibial fixation in TKA:a secondcoming.Orthopedics. 2010;33(9):655.
[25] 恩和,陈继营,杨瑞,等.普通非骨水泥股骨柄用于髋关节翻修的临床分析[J]. 解放军医学院学报,2013,34(10):1016-1019.
[26] Lerch M, von der Haar-Tran A, Windhagen H. Bone remodelling around the Metha short stem in total hip arthroplasty: a prospective dual-energy X-ray absorptiometry study. Int Orthop. 2012;36(3):533-538.
[27] 陈希聪,周观明,黎慧萍,等.保留股骨颈与传统非骨水泥股骨柄全髋置换术后早期股骨假体周围骨密度变化对比[J].海南医学, 2013,24(1):31-34.
[28] Weiss RJ，Stark A，Kärrholm J. A modular cementless stem vs. cemented long-stem prostheses in revision surgery of the hip:a population-based study from the Swedish Hip Arthroplasty Register. Acta Orthop. 2011;82(2):136-142.
[29] Garcia-Cimbrelo E，Garcia-Rey E，Cruz-Pardos A. The extent of the bone defect affects the outcome of femoral Reconstruction in revision surgery with impacted bone grafting: a five- to 17-year follow-up study. J Bone Joint Surg Br.2011;93(11):1457-1464.
[30] 胡钦胜,杨静,沈彬,等.非骨水泥长柄假体在髋关节翻修术中的应用[J].中华关节外科杂志(电子版),2013,7(5):615-621.
[31] Holt G, Hook S, Hubble M. Revision total hip arthroplasty ： the femoral side using cemented implants. Int Orthop. 2011; 35(2):267-273.
[32] 李朋,朱智奇,侯明,等. Zweymüller SLR-Plus 非骨水泥柄用于髋关节翻修的中期效果[J].中国组织工程研究,2014,18(35): 5600-5605.
[33] Hwang KT, Kim YH, Kim YS, et al. Total hip arthroplasty using cementless grit-blasted femoral component:a minimum 10-year follow-up study. J Arthroplasty. 2012;27(8): 1554- 1561.
[34] 张晓岗,阿斯哈尔江•买买提依明,曹力,等.非骨水泥型人工关节置换治疗老年不稳定股骨转子问骨折[J].中华骨科杂志,2012, 32(7):631-636.
[35] Hailer NP, Weiss RJ, Stark A, et al. The risk of revision due to dislocation after total hip arthroplasty depends on surgical approach, femoral head size, sex, and primary diagnosis. An analysis of 78，098 operations in the Swedish Hip Arthroplasty Register.Acta Orthop. 2012;83(5):442-448.
[36] 高文,王磊,邓雄.非骨水泥型全涂层矩形柄假体置换术治疗老年不稳定型股骨粗隆间骨折疗效观察[J].山东医药,2013,53(39): 72-73.
[37] Jibodh SR, Schwarzkopf R, Anthony SG, et al. Revision hip arthroplasty with a modular cementless stem：Mid-Term follow up. J Arthroplasty. 2012;(12):551-559.
[38] 唐颂军,刘伟,李晓华.类风湿性关节炎继发髋臼内陷的髋关节置换[J].中国组织工程研究, 2013,17(22):4144-4151.
[39] 高文,王磊,邓雄.非骨水泥型全涂层矩形柄假体置换术治疗老年不稳定型股骨粗隆间骨折疗效观察[J].山东医药, 2013, 53(39): 72-73.
[40] 庞向华,欧阳建江,欧兆强,等.隐性失血与全髋关节置换术后髋关节功能的相关性及影响因素[J].广东医学, 2013,34(03): 420-422.