| 非骨水泥股骨柄假体的中期疗效分析 |
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Received:January 23, 2011
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| 期刊信息：《中国骨伤》2011年24卷，第6期，第451-455页 |
| DOI：10.3969/j.issn.1003-0034.2011.06.003 |
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目的：通过对一组行人工全髋关节置换术(THA)随访6～10年的病例进行回顾性分析，探讨非骨水泥股骨柄假体中期效果及其影响因素。
方法：收集2000年1月至2003年12月初次行非骨水泥型人工髋关节置换术并获得完整随访的58例患者，男27例，女31例；手术时年龄25～73岁，平均56岁。随访从术前开始，术后于1.5、3、6、12个月随访评估，以后每年1次，采用Harris评分对患者进行功能评价，并按Gruen股骨分区行假体周围骨溶解发生率的影像分析。数据采用SPSS 16.0软件进行分析。
结果：随访时间6～10年，平均8.2年。Harris评分术前平均(54.0±7.8)分，术后最后一次随访时平均(88.3±6.1)分，优32例，良22例，可3例，差1例。影像学分析：48例达骨长入稳定，10例纤维稳定。4例出现了轻度下沉(1～3 mm);4例观察到骨溶解，以Ⅰ、Ⅵ、Ⅶ区较高，与其他区相比差异有统计学意义(P=0.031).同时假体柄是否与股骨髓腔匹配和髓腔形态有关。
结论：非骨水泥假体柄的稳定性高，无松动，中期临床表现良好。 |
| [关键词]:关节成形术，置换，髋 手术后并发症 功能恢复 治疗效果 |
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| Medium-term therapeutic evaluation of an uncemented femoral component |
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Abstract:
Objective: To study the clinical and radiographic results of tatal hip arthroplasty(THA) with an uncemented femoral component after 6 to 10 years follow-up,and to investigate factors effecting their efficacy.
Methods: From January 2000 to December 2003,58 patients were treated with primary total hip arthroplasty. Among the patients,27 patients were male and 31 patients were female,ranging in age from 25 to 73 years,with an average of 56 years. The 58 patients were clinically and radiographically followed up including before operation,postoperative 1.5,3,6 and 12 months,and then once a year. Therapeutic evaluation was measured by using Harris scoring system. The incidence of osteolysis around the components in different Gruen zones was radiologically determined. The data were analyzed by SPSS 16.0 software.
Results: All the patients were followed up,and the duration ranged from 6 to 10 years,with a mean of 8.2 years. The Harris hip score of the patients improved from preoperative mean of(54.0±7.8)to(88.3±6.1) at the latest follow-up. There were 32 patients with an excellent result,22 good,3 fair and 1 poor. Radiological analysis showed that 48 patients had stable bone in growth,10 patients got stable fibrous in growth and nobody showed unstable fixation with aseptic loosening. Subsidence(1 to 3 mm) was observed in 4 patients. Osteolysis of the femoral cortex was seen in 4 patients without progressive development,and the latest follow-up radiographs showed a significantly greater incidence of osteolysis in Gruen zoneⅠ，Ⅵ，Ⅶcompared with others(P=0.031). All the patients with low Harris score had received prostheses which were undersized in the intramedullary canal,and these differences were statistically significant.
Conclusion: The uncemented femoral component has good medium-term clinical follow-up results because of high stability and no aseptic loosening. |
| KEYWORDS:Arthroplasty,replacement,hip Postoperative complications Recovery of function Treatment outcome |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 甄建国,张卫国.非骨水泥股骨柄假体的中期疗效分析[J].中国骨伤,2011,24(6):451~455 |
| 英文格式: | ZHEN Jian-guo,ZHEN Jian-guo.Medium-term therapeutic evaluation of an uncemented femoral component[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(6):451~455 |
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