摘要
目的探讨人工髋关节置换术后骨水泥假体发生无菌性松动的原因及翻修技巧。方法自1997年3月～2006年6月,对36例42髋骨水泥假体发生无菌性松动的关节进行髋关节翻修术,术中彻底清除骨水泥、界膜,植入非骨水泥假体。术后随访时间为6～66个月,平均24个月。结果所有患者髋关节无疼痛。X线片示假体位置满意、无松动,植骨处愈合良好,骨质改善。Harris评分由平均34.8分(6～54分)提高到平均88.4分(60～94分)。结论骨水泥和骨之间的界膜是假体发生无菌性松动的主要原因。彻底清除骨水泥、界膜是翻修手术成功的关键。使用生物型双锥面螺旋臼及无极递增型非骨水泥假体,临床效果满意。
Objective To analyze the causes of the loosening of cement prosthesis after total hip arthroplasty and explore the technique for the revision. Methods Thirty- six patient with 42 hips underwent revision arthroplasty after primary total hip cement arthroplasty because of aseptic loosening. The cement and interface tissue were completely removed, and non- cement prosthesis was implanted. The mean follow- up period was 24 months （ranging 6 to 66 months）. Results All patients were free from pain and satisfied with the results. Radiograph demonstrated no evidence of loosening or subsidence, presented trabecular remodeling of both the graft and host bone. The Harris hip score increased from pre- operative 34.8 points （6- 54 points） to post- operative 88.4 points （60- 94 points）. Conclusion The interface tissue between bone cement and host bone mainly contributes to the loosening of prosthesis. It is critical to completely remove the bone cement and interface tissue for the success of the revision. The result of hip revision with tapered, rectangular gritblasted titanium stem with a conical threaded or Muller cups without cement are clinically satisfactory.
出处
《中国骨与关节损伤杂志》
2008年第8期632-634,共3页
Chinese Journal of Bone and Joint Injury
