| 金属对金属新假体临床使用体会 |
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投稿时间：2009-07-24
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| 作者 | Author | 单位 | Address | E-Mail |
| 李永奖 |
LI Yong-jiang |
温州医学院附属第三医院骨科,浙江 瑞安 325200 |
Department of Orthopaedics,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,Zhejiang,China |
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| 杨国敬 |
YANG Guo-jing |
温州医学院附属第三医院骨科,浙江 瑞安 325200 |
Department of Orthopaedics,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,Zhejiang,China |
jointlyj@126.com |
| 蔡春元 |
CAI Chun-yuan |
温州医学院附属第三医院骨科,浙江 瑞安 325200 |
Department of Orthopaedics,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,Zhejiang,China |
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| 张力成 |
ZHANG Li-cheng |
温州医学院附属第三医院骨科,浙江 瑞安 325200 |
Department of Orthopaedics,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,Zhejiang,China |
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| 林瑞新 |
LIN Rui-xin |
温州医学院附属第三医院骨科,浙江 瑞安 325200 |
Department of Orthopaedics,the Third Affiliated Hospital of Wenzhou Medical College,Rui'an 325200,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年，第23卷，第1期，第42-45页 |
| DOI：10.3969/j.issn.1003-0034.2010.01.013 |
| 基金项目: |
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中文摘要:
目的：探讨金属对金属大头(ASRTM XL)全髋关节置换术的早期疗效和临床体会，以及该技术的安全性和有效性。
方法：2007年1月至2008年3月，采用金属对金属大头全髋关节置换术治疗37例(39髋)髋关节疾患，男24例，女13例；年龄43～75岁，平均58.5岁。其中股骨头坏死14例、骨性关节炎2例、新鲜股骨颈骨折18例、先天性髋关节发育不良3例。结合手术前后患者髋关节功能检查、Harris评分及X线分析，对金属大头全髋的临床应用特点进行分析。
结果：术后患者伤口均Ⅰ期临床愈合，无早期并发症发生。37例(39髋)均获随访，随访时间12～19个月，平均16.5个月。术后X线片显示关节假体位置良好，肢体长度及股骨偏心距基本恢复正常。髋关节活动度得到大幅改善，前屈由(20.1±8.2)°增加到(85.7±9.8)°(t=32.86,P<0.01),外展由(10.2±4.4)°增加到(41.5±9.1)°(t=19.34,P<0.01),内收由(16.3±8.8)°增加到(40.3±10.4)°(t=11.00,P<0.01),外旋由(12.3±5.2)°增加到(42.0±7.7)°(t=19.96,P<0.01),内旋由(3.4±1.1)°增加到(23.0±9.8)°(t=12.41,P<0.01).Harris髋关节评分从术前(39.3±5.6) 分提高到最后随访的 (91.4±10.3)分(t= 27.75,P<0.01).
结论：金属对金属大头全髋假体设计具有臼杯变形小、磨损率低、活动范围大、脱位发生率低等特点。其为治疗术后活动量要求较高的髋关节疾病如股骨头缺血性坏死、骨关节炎、股骨颈骨折、髋发育不良患者提供了一种新的有价值的手术方式。 |
| 【关键词】关节成形术，置换，髋 金属对金属 大直径头 髋关节假体 |
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| Clinical apprehension on application of metal on metal total hip arthroplasty with large diameter heads |
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ABSTRACT
Objective: To approach the short-term result and clinical application of metal on metal total hip arthroplasty with large diameter heads and evaluate its safety and efficacy clinically.
Methods: From January 2007 to March 2008,39 hips in 37 patients(24 males and 13 females,ranging in age from 43 to 75 years,with an average of 58.5 years) were treated with metal on metal total hip arthroplasty with large diameter heads (ASRTM XL) included 14 cases of osteonecrosis(ON),2 cases of osteoarthritis(OA),18 cases of fresh femoral neck fracture,3 cases of developmental dysplasia of the hip(DDH). All patients were evaluated by self assessment form,hip function examination,radiographs,preoperative and postoperative Harris hip score. Based on the short-term results,its design characteristic and clinical properties were analyzed.
Results: All the incision healed well and there were not any complications such as femoral fracture,infection,dislocation and neurovascular injury. All patients obtained the follow-up and an average time was 16.5 months(12 to 19 months),all the joints had good or excellent clinical results. Radiographically,the positions of the prostheses were normal,the average limbs length and femoral eccentricity recovered as normal. The average range of motion of the hip improved remarkable,such as flexion improved from(20.1±8.2)° to(85.7±9.8)°(t=32.86,P<0.01),abduction improved from(10.2±4.4)° to(41.5±9.1)°(t=19.34,P<0.01),adduction improved from (16.3±8.8)° to(40.3±10.4)°(t=11.00,P<0.01),external rotation improved from (12.3±5.2)° to(42.0±7.7)°(t=19.96,P<0.01),internal rotation improved from (3.4±1.1)° to (23.0±9.8)°(t=12.41,P<0.01). The Harris score rose from preoperative (39.3±5.6) to (91.4±10.3) at the latest follow up(t= 27.75,P<0.01).
Conclusion: Short-term results show that metal on metal hip joint prosthesis with large diameter heads has advantages of small deformation of acetabular cup,lower wearing,large range of motion and few dislocation. It offers a newly valuable technology for treatment of osteonecrosis,osteoarthritis,femoral neck fracture and DDH with the higher requirement of movement after the operation. |
| KEY WORDS Arthroplasty,replacement,hip Metal on metal Large diameter head Hip prosthesis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李永奖,杨国敬,蔡春元,张力成,林瑞新.金属对金属新假体临床使用体会[J].中国骨伤,2010,23(1):42~45 |
| 英文格式: | LI Yong-jiang,YANG Guo-jing,CAI Chun-yuan,ZHANG Li-cheng,LIN Rui-xin.Clinical apprehension on application of metal on metal total hip arthroplasty with large diameter heads[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(1):42~45 |
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