| 人工髋关节翻修的股骨假体柄的形态及稳定性的临床观察 |
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| 作者 | Author | 单位 | Unit | E-Mail |
| 闵重函 |
MIN Zhong-han |
浙江中医药大学附属嘉兴中医院骨科12病区, 浙江嘉兴 314001 |
Department of Orthopaedics, Jiaxing Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Jiaxing 314001, Zhejiang, China |
min.af.1@163.com |
| 张洪美 |
ZHANG Hong-mei |
中国中医科学院望京医院骨关节一科, 北京 100102 |
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| 周瑛 |
ZHOU Ying |
浙江中医药大学附属嘉兴中医院骨科12病区, 浙江嘉兴 314001 |
Department of Orthopaedics, Jiaxing Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Jiaxing 314001, Zhejiang, China |
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| 严世贵 |
YAN Shi-gui |
浙江大学附属医学院附属第二医院骨科, 浙江杭州 310052 |
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| 秦宏敏 |
QIN Hong-min |
攀枝花市中西医结合医院骨科, 四川攀枝花 3347772 |
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| 叶先才 |
YE Xian-cai |
浙江嘉兴学院医学院, 浙江嘉兴 314001 |
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| 朱振康 |
ZHU Zhen-kang |
浙江中医药大学附属嘉兴中医院骨科12病区, 浙江嘉兴 314001 |
Department of Orthopaedics, Jiaxing Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Jiaxing 314001, Zhejiang, China |
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| 荆琳 |
JING Lin |
中国中医科学院望京医院骨关节一科, 北京 100102 |
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| 赵革军 |
ZHAO Ge-jun |
浙江中医药大学附属嘉兴中医院骨科12病区, 浙江嘉兴 314001 |
Department of Orthopaedics, Jiaxing Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Jiaxing 314001, Zhejiang, China |
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| 期刊信息：《中国骨伤》2015年28卷，第3期，第205-209页 |
| DOI：10.3969/j.issn.1003-0034.2015.03.003 |
| 基金项目:浙江省科技厅项目(编号:2011C33050);嘉兴市科技局项目(编号:2011AY1051-2) |
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目的:根据全髋关节翻修所得资料,分析人工股骨柄在生理应力作用下的状态,讨论延长人工关节使用年限的注意事项,为临床工作积累更多经验。
方法:选择53例单侧全髋关节置换术后需要行翻修手术的患者,其中男28例,女25例;平均年龄74.66岁(61～84岁).人工关节平均使用年限18.24年(3～27年),首次置换术后初始下地负重时间平均11 d(5～16 d),翻修的主要原因为自发松动和外伤。根据患者影像学资料和手术直观所见进行分析,并根据组织学病理做出推断。
结果:股骨柄假体在生理应力下存在微动沉降,其二次稳定与股骨柄设计、患者动态、骨质和骨长入性状有关。直柄假体有利于生理性沉降,实现紧密接触的骨长入稳定,可以在患者条件允许下早期负重锻炼。有领假体和结合内固定假体限制股骨柄沉降,其稳定性取决于首次安置时的压配和后期骨长入支撑,对该类患者建议延长非负重时间。
结论:根据患者实际情况,选择恰当的股骨假体和下地负重时机可以延长股骨假体的使用年限,减少松动概率。 |
| [关键词]:翻修 髋关节 关节成形术,置换,髋 |
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| Analysis on morphology and stability of femoral hip prosthesis based on the revision operation |
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Abstract:
Objective:According to the information obtained from the revision of total hip arthroplasty,the situations of the artificial femoral stem under physiological stress were analyzed preliminarily. In order to accumulate clinical experience,the discussions about how to enlongate the life of artifical joints were performed.
Methods:Fifty-three patients required revision operations were selected,including 28 males and 25 females,with an average age of 74.66 years old(61 to 84 years old). The average life of artificial joints was 18.24 years (3 to 27 years). The initial weightbearing was started 11 days (5 to 16 days) after the first operation. The main reasons for the revision were the spontaneous loosening and trauma. Based on imaging and surgical findings,as well as the histological pathology,the situations of the stems in human bodies were determined.
Results:Femoral prosthesis would sink under physiological stress. The design of femoral stems,motion of patients',and bone growth determined the secondary stability. Straight stems were helpful for physiological subsidence of prosthesis,achieving the stability with close bone-implant contact by bone growth,which allowed the patient to do early landing exercise. The collared prosthesis and prosthesis combined with internal fixation limited the subsidence of femoral stems. Their stability depends on the time of initial placement and the bone growth for supporting. Delaying the inital weightbearing was suggested for patients with these protheses.
Conclusion:According to the actual situation of the patients,the appropriate chosen of femoral stems and time to perform the weightbearing can extend the life of the femoral prosthesis. |
| KEYWORDS:Revision Hip joint Arthroplasty,replacement,hip |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闵重函,张洪美,周瑛,严世贵,秦宏敏,叶先才,朱振康,荆琳,赵革军.人工髋关节翻修的股骨假体柄的形态及稳定性的临床观察[J].中国骨伤,2015,28(3):205~209 |
| 英文格式: | MIN Zhong-han,ZHANG Hong-mei,ZHOU Ying,YAN Shi-gui,QIN Hong-min,YE Xian-cai,ZHU Zhen-kang,JING Lin,ZHAO Ge-jun.Analysis on morphology and stability of femoral hip prosthesis based on the revision operation[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(3):205~209 |
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