非骨水泥假体髋关节翻修术随访报告

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1、非骨水泥假体髋关节翻修术随访报告编辑。作者：李朋，史占军，管明强，肖军，王健【摘要】［目的］探讨非骨水泥假体在髋关节翻修术中的临床效果。［方法］对本科1997年11月～XX年8月行非骨水泥人工全髋关节翻修术36例患者进行了随访，其中29髋行全髋关节翻修，8髋仅翻修髋臼，4髋仅更换股骨柄。随访X线片上的假体变化情况，分析AAOS、Paprosky骨缺损分类对翻修时假体选择的指导作用，对髋关节行Harris功能评定并分析假体生存率。［结果］24例28髋获得随访，平均随访年，患者平均Harris评分由术前的

2、38分增加到末次随访时的88分。21髋假体获得良好稳定性；1髋股骨1区形成mm宽的透亮线，临床检查无松动迹象；4髋发生骨溶解并假体移位而需要再翻修，失败率为12.%；8髋发生异位骨化；聚乙烯衬垫年平均磨损量为，磨损率仅与外展角变化存在相关。AAOS分类术前、术中的一致性较Parprosky分类高。分别以任何原因进行了再翻修和影像学证明假体松动作为失败标准，利用KaplanMEier生存分析计算假体年存活率分别为89%、81%。［结论］非骨水泥型假体可用于初次髋关节置换术失败的翻修。术中对骨缺损进行细

3、致的评估并选择合适的假体固定，能达到令人较满意的临床效果。【关键词】关节成形术；髋；翻修术；非骨水泥；随访Abstract：［Objective］Toevaluatetheclinicalandradiographicresultsofrevisionhiparthroplastywithcementlessprothesis.［Method］Revisionhiparthroplastyof1hipsinpatientswasperformedfromNovember199toAugust00usi

4、ngcementlessthe1hips,2hipsunderwentarevisiontotalhiparthroplasty,hipsunderwentnewacetabularcomponents,andhipsunderwentstemradiographswerecomparedtoevaluatecomponentvalueofAAOSandPaproskyclassificationwashipscores(HHSs)weredeterminedbeforesurgeryandatthe

5、mostrecentfollowupKaplanMEIersurvivorshipanalysiswasusedtoestimatetheprobabilityofsurvivaloftheprothesis.［Result］Twentytwopatients(2hips)wereavailableforcompleteclinicalandradiographicmeanfollowupperiod(range,1-11years).ThemeanpreoperativeHarriships

6、coreof(range,11-76)pointsimprovedto(range,60-99)pointsatthetimeoffinalfollowpainandfunctionsocreimprovedfrom,patientshadmoderatetoseverelimpbeforethetimeoffinalfollowup,patientsstillhadslightlimpandpatientshadmoderateonehips(75%)hadanexcellent1mmwidt

7、hradiolucentlinewasfoundin1femoralcomponentwithoutanyandmigrationwereseeninhips(inacetabularand1infemoralcomponent),whichneededrerevision(%failure).Heterotopicossificationdevelopedinhips(31%).Themeanpolyethylenelinerwearwasallandwearratewasonlycorrelat

8、edwithchangesofabductionangleofthecoincidenceofbonedefectclassificationinAAOSisbetterthanMeiersurvivorshipwas9%withrepeatrevisionforanyreasonastheendpointand1%withrepeatrevisionorradiographiclooseningastheendpoint.［Conclusion］Ce