[1]许杨,凌义龙,韦金忠,等.长柄全涂层表面微孔股骨假体在人工全髋关节翻修术中的应用[J].中医正骨,2016,28(09):49-51.
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长柄全涂层表面微孔股骨假体在人工全髋关节翻修术中的应用()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年09期
页码:
49-51
栏目:
临床报道
出版日期:
2016-09-20

文章信息/Info

作者:
许杨; 凌义龙; 韦金忠; 魏平洋; 刘磊; 夏炳江; 钱淼忠
浙江省绍兴市中医院,浙江 绍兴 312000
关键词:
髋假体;  关节成形术; 置换; 髋;  假体失效;  假体周围骨折;  假体相关感染;  再手术
摘要:
目的:观察长柄全涂层表面微孔股骨假体用于人工全髋关节翻修术的临床疗效及安全性。方法:2010年1月至2015年12月,采用长柄全涂层表面微孔股骨假体对曾经接受人工全髋关节置换术的16例患者行翻修手术,男7例、女9例。年龄47～86岁,中位数61岁。均为初次行翻修术的患者。左侧9例,右侧7例。髋关节翻修原因,假体无菌性松动12例,其中单纯股骨侧假体松动5例、股骨侧合并髋臼侧假体松动4例、单纯髋臼侧假体松动3例; 股骨侧假体无菌性松动合并股骨假体周围骨折2例; 人工全髋关节置换术后感染2例。股骨侧骨缺损程度按照Paprosky分型标准,Ⅰ型12例、Ⅱ型4例。初次行人工全髋关节置换术至本次翻修手术间隔时间为3.5～19年,中位数9.6年。随访观察股骨假体稳定性、髋关节活动度及功能、双下肢不等长距离及并发症发生情况。结果:所有患者均获随访,随访时间6个月至5年,中位数2.5年。股骨假体稳定性良好,获得骨长入固定14例、稳定的纤维固定2例。所有患者均未出现假体松动及感染。1例术中股骨干骨折,采用钢板及螺钉固定,并延期负重活动。2例股骨假体下沉<5 mm,但无明显临床症状。翻修术后2周,Harris髋关节功能评分较术前增高[(43.1±8.2)分,(85.2±11.8)分,t=9.909,P=0.000]。翻修术后5个月,髋关节屈曲、伸直、外展及外旋活动度均较术前改善[(45.0°±10.9°),(102.6°±18.2°),t=8.612,P=0.000;(-6.9°±2.0°),(2.9°±1.2°),t=13.622,P=0.000;(14.8°±3.7°),(33.2°±5.3°),t=8.854,P=0.000;(13.1°±4.0°),(28.2°±6.4°),t=6.781,P=0.000],双下肢不等长距离短于术前[(2.1±0.4)cm,(0.9±0.3)cm,t=7.348,P=0.000]。结论:采用长柄全涂层表面微孔股骨假体行人工全髋关节翻修术,假体稳定性高、髋关节功能及活动度恢复良好、并发症少,值得临床推广应用。

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备注/Memo

备注/Memo:
2016-06-03收稿 2016-07-19修回

更新日期/Last Update: 1900-01-01