人工髋关节翻修术29例临床效果分析.docVIP

人工髋关节翻修术29例临床效果分析 　　[摘要] 目的：探讨人工髋关节置换术后翻修的主要原因及髋臼骨缺损的处理方法。方法：选择2005年6月~2010年6月我院髋臼骨缺损患者29例（29个髋关节）行翻修术，采用打压颗粒植骨、髋臼假体置换重建髋臼骨缺损后进行假体固定。应用Harris评分标准及髋正位片评价临床治疗效果。结果：行髋关节置换翻修术的主要原因为无菌性假体松动。本研究29例患者到随访结束时均无明显骨吸收及假体位置变化。经Harris评分显示，术前患者平均得分为（37.5±7.9）分，末次随访时平均得分为（91.3±8.3）分，差异有高度统计学意义（P＜0.001）。结论：无菌性假体松动是人工髋关节翻修的主要原因，而打压颗粒植骨联合髋臼假体置换能合理、有效地重建缺损的髋臼骨。 　　[关键词] 髋关节置换术；翻修；髋臼骨缺损 　　[中图分类号] R687.4 [文献标识码] B [文章编号] 1673-7210（2011）12（a）-182-02 　　 　　Clinical effect analysis of revision hip arthroplasty in 29 cases 　　WANG Zhihong 　　Department of Orthopedics, the Fourth Peoples Hospital of Changde City, Hunan Province 415000, China 　　[Abstract] Objective: To investigate the main reason of revision hip arthroplasty and the management method of acetabular bone defect. Methods: From June 2005 to June 2010, 29 cases of patients (29 hips) with acetabular bone defect in our hospital who were treated with revision total hip arthroplasty were reviewed. Particulate cancellous bone impaction grafting and THA were used to reconstruct acetabular bone defect, then prosthesis were fixed. The Harris hip score and the AP view of hip were obtained to assess the outcome. Results: Aseptic prosthesis loosening was the main reason for revision hip arthroplasty. There were no significant change of bone resorption and no implant migration at the end of follow-up. Harris hip score showed that preoperative average score was (37.5±7.9) scores and the last follow-up score was (91.3±8.3) scores, the difference was statistically significant (P＜0.001). Conclusion: Aseptic prosthesis loosening is the main reason for revision total hip arthroplasty, while particulate cancellous bone impaction grafting and acetabular prosthesis replacement can reconstruct the acetabular bone defect reasonably and effectively. 　　[Key words] Total hip arthroplasty; Revision; Acetabular bone defect 　　随着人工髋关节置换术的日益普及，因各种原因需进行人工髋关节翻修术的患者逐渐增多[1]。据调查，人工髋关节置换术术后5年翻修率为6%，术后10年有12%的患者需要翻修[2]。人工髋关节翻修术是目前解除或缓解疼痛、最大限度恢复骨残端，从而获得具有稳定、良好功能