摘要
目的 探讨第4代陶瓷对陶瓷界面假体行全髋关节置换术(THA)的疗效。方法 采用第4代陶瓷对陶瓷界面假体行THA治疗30例终末期髋关节疾病患者。记录并发症发生情况,采用Harris评分和UCLA评分评估髋关节功能及活动水平。测量髋臼杯假体的外展角和前倾角以评价髋臼杯安装是否在安全区范围。结果 患者均获得随访,时间24~46个月。切口均一期愈合,未发生神经、血管损伤。1髋出现关节异响现象。末次随访时,患者均无大腿痛,股骨及髋臼假体均获骨长入性固定,无因出现骨溶解、假体松动及感染等并发症而行翻修手术;29例步态恢复正常,1例轻度跛行。Harris评分由术前28~68(47.83±13.45)分提高到末次随访的85~98(92.60±3.12)分(P<0.01),其中优25例,良5例,优良率为100%。UCLA评分由术前2~6(4.27±1.51)分提高到末次随访的5~10(7.53±1.78)分(P<0.01)。末次随访时,髋臼外展角28°~55°(40.8°±7.6°),髋臼前倾角10°~26°(16.0°±4.1°),髋臼杯均在安全区范围。结论 第4代陶瓷对陶瓷界面假体行THA治疗终末期髋关节疾病,患者关节功能恢复较好,术后并发症少。
Objective To investigate the effect of total hip arthroplasty(THA)with the fourth-generation ceramic-on-ceramic bearings prosthesis.Methods The 30 patients of end-stage hip disease were treated by THA using the fourth-generation ceramic-on-ceramic bearings prosthesis.Complications were recorded,the hip function and mobility level were assessed by using Harris score and UCLA score.The abduction angle and anterior inclination angle of the acetabular cup prosthesis were measured to evaluate whether the acetabular cup installation was within the safe zone.Results All patients were followed up for 24~46 months.All incisions healed in one-stage,and no nerve or vascular injury occurred.Abnormal joint sound occurred in 1 hip.At the last follow-up,none of the patients had thigh pain,and the femur and acetabular prostheses were obtained ingrown fixation,and no revision surgery was performed due to osteolysis,prostheses loosening or infection.Twenty-nine patients returned to normal gait,and 1 case had mild claudication.At the last follow-up,Harris scores were increased from preoperative 28~68(47.83±13.45)points to 85~98(92.60±3.12)points(P<0.01),of which 25 cases were excellent and 5 cases were good,the excellent-good rate was 100%.The UCLA scores were increased from 2~6(4.27±1.51)points before surgery to 5~10(7.53±1.78)points at the last follow-up(P<0.01).At the last follow-up,the acetabular abduction angle was 28°~55°(40.8°±7.6°),the acetabular anterior inclination angle was 10°~26°(16.0°±4.1°),and the acetabular cups were all in the safe zone.Conclusions In THA treatment of end-stage hip disease,the fourth-generation ceramic-on-ceramic bearings prosthesis has better joint function recovery and few postoperative complications.
作者
游镇君
蒋毅
吴可沁
YOU Zhen-jun;JIANG Yi;WU Ke-qin(Dept of Orthopaedics,the First Hospital of Jiaxing City,Jiaxing,Zhejiang 314000,China)
出处
《临床骨科杂志》
2024年第3期328-331,共4页
Journal of Clinical Orthopaedics
基金
浙江省卫健委医药卫生科技计划项目(编号:2021KY1102)。
关键词
全髋关节置换术
第4代陶瓷
陶瓷界面假体
骨溶解
假体松动
total hip arthroplasty
the fourth-generation ceramic
ceramic bearings prosthesis
osteolysis
prosthesis loosening
