陶瓷对陶瓷全髋关节置换治疗中青年股骨颈骨折的分析.docVIP

陶瓷对陶瓷全髋关节置换治疗中青年股骨颈骨折的分析☆ 侯喜君，李 霖，王春华，李玉强(秦皇岛市第一医院骨三科，河北省秦皇岛市 066000) 文章亮点： 1文章特点显示了陶瓷对陶瓷假体极低的界面之间的磨损率。理想的陶瓷髋臼置放角度应当为外展40°-45°，前°-20°，以获得较大的头臼接触面积，分散关节内外应力，避免边缘应力的产生，进而造成假体碎裂。 2 结果提示在安装假体时应该注意避免人工髋关节过度松弛。在假体试模安装完成后应适当牵拉下肢以观察髋臼与球头之间的松紧程度及撞击情况，根据观察结果可以适当调整球头规格以调整内衬与球头之间的松紧度。最后在假体安装完成后应检查并清除髋臼周围存在的骨赘，防止骨赘与球头的碰撞，从而造成假体碎裂。 关键词： 骨关节植入物；人工假体；关节成形术，髋；假体；陶瓷；骨折；股骨颈；中青年；并发症 主题词： 关节成形术，髋；髋假体；陶瓷制品；股骨颈骨折 摘要 背景：陶瓷对陶瓷全髋关节置换适用于活动量较大、生活质量要求较高的年轻患者。 目的：分析陶瓷对陶瓷全髋关节置换治疗青壮年患者股骨颈骨折近期治疗效果。 方法：使用陶瓷对陶瓷全髋关节置换治疗的年龄在50岁以下的中青年股骨颈骨折患者51例，评估患者治疗后髋关节功能及并发症。 结果与结论：所有患者均获随访，随访时间6个月至3年8个月。末次随访时，Harris 评分为(92.0±3.4)分，优良率 94.1%。置换后无关节脱位病例发生，3例轻度跛行，均未作特殊处理。至随访结束影像学检查结果显示，未见假体松动、下沉及碎裂发生，假体周围无透亮线形成。陶瓷对陶瓷人工髋关节置换治疗活动量相对较大的青壮年患者股骨颈骨折能有效减少因磨损碎屑造成的骨溶解，减少假体的松动及下沉，延长关节的使用寿命，改善患者的生活质量。 Ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fracture Hou Xi-jun, Li Lin, Wang Chun-hua, Li Yu-qiang (Third Department of Orthopedics, Qinhuangdao First Hospital, Qinhuangdao 066000, Hebei Province, China) Abstract BACKGROUND: Ceramic-on-ceramic total hip arthroplasty can be applied to young patients requiring frequent activity and high quality of life. OBJECTIVE: To explore the short-term efficiency of ceramic-on-ceramic total hip arthroplasty in young and middle-aged patients of femoral neck fractures. METHODS: Fifty-one young and middle-aged patients under 50 years old with ceramic-on-ceramic total hip arthroplasty were selected to analyze the function of hip joints and the complication after operation. RESULTS AND CONCLUSION: All the patients were followed up for 6 months to 44 months. At the last follow-up, the average Harris score was 92.0±3.4 points with an excellent and good rate of 94.1%. No dislocation was observed and three cases exhibited mild limping. Imaging examination showed that, no prosthesis loosing, broken, sinking or radiolucent line around prosthesis was observed. Ceramic-on-ceramic total hip arthroplasty in young patients with femoral neck fractur