摘要
目的对髋关节置换术后失败的原因进行分析,评价翻修术的疗效。方法回顾性分析行髋关节翻修67例,按翻修原因分为无菌松动、感染、脱位、假体周围骨折及假体柄断裂五组,分析不同原因在初次置换术后不同时期的分布以及翻修术后的疗效。结果 67例病人中,无菌性松动39例(58.21%),感染15例(22.39%),脱位6例(8.96%),假体周围骨折6例(8.96%),假体折断1例(1.48%)。其中,早期翻修32例(47.76%),中期翻修17例(25.37%),晚期翻修18例(26.87%)。翻修术前的Harris评分(49.47±9.27)分,翻修术后Harris评分(87.06±5.07)分,翻修术后效果优22例(32.83%),良39例(58.21%),可6例(8.96%)。结论髋关节置换术后失败的主要原因有无菌性松动、感染。感染、脱位、假体周围骨折等,主要发生在髋关节置换术后早期,而无菌松动在各期分布差异无统计学意义。翻修术是补救髋关节置换术后失败的有效方法。
Objective To analyze the causes of the failure after hip replacement and to evaluate the effect of revision procedures. Methods We retrospectively analyzed hip revision of the 67 patients admitted to hospital during January 2010 to January 2016 in the First Affiliated Hospital of Anhui Medical University. The reasons for revision procedures were divided into aseptic loosening,infection,dislocation,prosthesis peripheral fracture and prosthesis handle fracture. This paper analyzed the distribution of reasons during different periods after the first replacement and postoperative effect. Results In the 67 patients,39 cases(58. 21%) resulting from aseptic loosening,15 cases(22. 39%) resulting from infection,6 cases(8. 96%) because of dislocation,6 cases(8. 96%) because of fracture around the prosthesis,and 1 case(1. 48%) because of prosthesis handle fracture. Among them,there were early revision 32 cases(47. 76%),mid-term revision 17 cases(25. 37%),and late revision 18 cases(26. 87%). Harris score was increased from preoperative 49. 47 ± 9. 27 to postoperative 87. 06 ± 5. 07. There were 22 cases with excellent recovery,39 cases with good recovery. The good rate was 91. 04%. Conclusions The main reasons for the failure of the hip replacement are aseptic loosening and infection. Infection,dislocation and prosthesis peripheral fracture mainly occur in early phase after hip replacement,and no significant difference is found between aseptic loosening distribution in each phase. Revision procedure is an effective way to remedy the failure of hip replacement.
出处
《安徽医药》
CAS
2017年第3期525-528,共4页
Anhui Medical and Pharmaceutical Journal
关键词
关节成形术
置换
髋/副作用
假体失效
再手术
治疗结果
Arthroplasty,replacement,hip/adverse effects
Prosthesisfailure
Reoperation
Treatment outcomes
