摘要
选择2000-02/2007-05在福建医科大学附属第二医院骨科进行髋关节翻修患者21例(21髋),均为股骨颈骨折行人工股骨头置换。其中男6例,女15例;年龄65～85岁,平均74岁。11例髋臼磨损、4例假体松动、2例松动合并髋臼磨损行全髋关节翻修,髋臼缺损部位行松质骨颗粒充填植骨,2例假体周围骨折患者行复位内固定植入长柄假体加周围植骨,2例感染患者行旷置后二期全髋关节翻修。翻修假体的选择:非骨水泥型假体7例,骨水泥型假体3例,混合型假体7例,2例保留假体柄,2例假体周围骨折仅行股骨侧翻修。平均随访32个月,Harris评分平均79分,翻修采用骨水泥假体比非骨水泥假体效果差。结果提示人工股骨头置换术后翻修最常见的原因是髋臼磨损,翻修手术尽量采用非骨水泥假体。
Twenty-one patients (21 hips) undergoing coax revision were enrolled at Department of Orthopaedics, Second Affiliated Hospital, Fujian Medical University from February 2000 to May 2007, including 6 males and 15 females, aged 65-85 years, averagely 74 years. All patients with femoral neck fracture received artificial femoral head replacement. There were 11 hips with acetabular erosion, 4 hips with prosthesis loose and 2 hips with prosthesis loose and acetabular erosion. Morselized bone graft was placed in the area of acetabular defect. Two patients (2 hips) with periprosthetic femoral fractures were treated by open reduction and internal fixation, long-stem prosthesis and bone graft around fractures. Two patients (2 hips) with infection were treated by secondary prosthetic reimplantation. The methods for revision were cementless component 7 hips, hybrid component 7 hips and cemented component 3 hips. Femoral prosthesis of 2 patients was not removed. Two hips with periprosthetic femoral fractures were revised only in the femur. The average follow-up was 32 months. The average score was 79 points according to Harris scoring system. Cementless arthroplasty was superior to cemented arthroplasty. The common reason of revision after artificial femoral head replacement is acetabular erosion. Cementless arthroplasty should be operated in revision after artificial femoral head replacement.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第51期10370-10373,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
