摘要
[目的]探讨大直径金属对金属（MOM）和陶瓷对陶瓷（COC）全髋置换术的手术体会及近期疗效。[方法]2009年4月～2010年1月，采用大直径MOM行全髋置换20例20髋，患者平均年龄（51．7±3．8）岁，平均体重指数（23．3±2．1）kg／m^2，术后随访（13±2）个月。采用COC行全髋置换19例20髋，患者平均年龄（53．1±2．9）岁，平均体重指数（23．8±2．6）kg／m^2，术后随访（15±2）个月。通过临床（Harris评分）和x线观察，对两组患者术后功能和影像学进行对比研究。[结果]本组无1例感染、骨折、脱位，无1例深静脉血栓及神经损伤等并发症。临床随访：两组术前Harris评分差异无统计学意义（P〉0．05），术后6周、3、6、t2个月Harris评分差异具有统计学意义（P〈0．05）。MOM组术后6个月大腿痛弱痛1例，无中、重度疼痛，COC组无1例大腿痛。术后1年MOM组髋关节总活动范围228．35°±9．72°，COC组髋关节总活动范围191．15°±10．59°，差异具有统计学意义（P〈0．05）。X线随访：39髋（97．5％）股骨假体位于中立位，1髋（2．5％）轻度外翻位，MOM组无1例股骨假体下沉，COC组术后6个月4髋出现〈1．5mm的下沉，末次随访股骨假体位置无改变。MOM组外展角平均40．05°±2．54°，COC组39．30°±2．70°，无统计学差异（P=0．654）；MOM组前倾角平均15．60°±2．68°，COC组15．25°±2．20°，亦无统计学差异（P=0．131）。[结论]大直径金属对金属（MOM）全髋置换术的近期疗效优于陶瓷对陶瓷（COC）全髋置换术，特别是在关节活动度和早期下床活动方面，良好的疗效与手术技巧密切相关，中远期疗效需进一步观察。
[ Objective ] To discuss the short - term results and operative experience of metal - on - metal （MOM） versus ceramic - on - ceramic （COC） hearing surfaces in total hip arthroplasty （THA） . [ Methods ] Between April 2009 and January 2010, We retrospectively reviewed 20 patients （20 hips） performed with the MOM THA. At an average of 13 months period （ range, 11 to 20 months ） postoperatively, all hips were available for follow - up. Their age was （51.7±3.8 ） years, and body mass index was （23.3 ±2. 1 ） kg/m^2 . For comparison , We retrospectively reviewed 19 patients （20 hips） performed with the COC THA at the same time. All patients obtained an average follow -up of 15 months （range, 11 to 20 months ） . Their age was （53.1 -＋ 2. 9 ） years, and body mass index was （23.8±2. 6） kg/m^2. The Harris hip Score was used for clinical evaluation. The roentgenographic results were observed. [ Results ] No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical results ： there were no difference between the 2 groups about preoperative Harris score （ P 〉 0. 05 ）, the differences between the 2 groups were significant at 6 weeks , 3, 6 and 12 months （P 〈0. 05） . In the MOM group, 1 patient had weak thigh pain was found, no moder- ate or severe pain. In the COC group, no one had thigh pain. In the MOM group, the total range of hip motion was 228.35° ±9.72°. In the COC group, it was 191.15° ± 10. 59°. Obvious su- periority was observed in 2 groups （ P 〈 0. 05 ） . Radiographic re-suits： 39 （97.5%） femoral stems were in neutral position and 1 was in mild valgus. No implant had subsidence in the MOM group. In the COC group, 4 hips had less than 1.5mm subsidence, and there was no change in the latest follow up. In the MOM group, the abduction component abduction angle was 40. 05° ±2. 54, whereas the abduction angle for the COC group was 39. 30° ±2. 70° （P =0. 654） . the anteversion angl
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第13期1067-1072,共6页
Orthopedic Journal of China
关键词
关节成形术
置换
髋
假体和植入物
随访研究
arthroplasty, replacement, hip, prosthesis and implants, follow-up studies
