李朋;史占军;管明强;肖军;王健;

• 1:南方医科大学附属南方医院脊柱骨病外科

摘要(Abstract)：

[目的]探讨非骨水泥假体在髋关节翻修术中的临床效果。[方法]对本科1997年11月～2007年8月行非骨水泥人工全髋关节翻修术36例(41髋)患者进行了随访,其中29髋行全髋关节翻修,8髋仅翻修髋臼,4髋仅更换股骨柄。随访X线片上的假体变化情况,分析AAOS、Paprosky骨缺损分类对翻修时假体选择的指导作用,对髋关节行Harris功能评定并分析假体生存率。[结果]24例28髋获得随访,平均随访4.6年(1～11年),患者平均Harris评分由术前的38分(11～76分)增加到末次随访时的88分(60～99分)。21髋(75%)假体获得良好稳定性;1髋股骨1区形成2mm宽的透亮线,临床检查无松动迹象;4髋发生骨溶解并假体移位(股骨1髋,髋臼3髋)而需要再翻修,失败率为12.5%;8髋发生异位骨化;聚乙烯衬垫年平均磨损量为0.08mm(0～0.25mm),磨损率仅与外展角变化存在相关。AAOS分类术前、术中的一致性较Parprosky分类高。分别以任何原因进行了再翻修和影像学证明假体松动作为失败标准,利用Kaplan-Meier生存分析计算假体4.6年存活率分别为89%、81%。[结论]非骨水泥型假体可用于初次髋关节置换术失败的翻修。术中对骨缺损进行细致的评估并选择合适的假体固定,能达到令人较满意的临床效果。

关键词(KeyWords)： 关节成形术;髋;翻修术;非骨水泥;随访

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 李朋;史占军;管明强;肖军;王健;

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参考文献(References)：

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