摘要
目的探讨生物型翻修加长柄治疗股骨假体松动伴股骨骨缺损的临床效果。方法回顾性分析于2011年1月至2015年1月在新疆沙雅县人民医院关节外科接受髋关节翻修术的患者,选取股骨柄松动并伴有股骨缺损且仅翻修股骨柄假体者,排除感染、髋臼假体问题、严重内科疾病及骨质疏松者,最终纳入病例104例,其中采用生物型翻修加长柄者归入观察组(n=52),采用水泥型翻修柄者归入对照组(n=52)。采用t检验对比分析两组的手术时间、术中出血量、住院时间、骨折愈合时间、相关功能评分。两组优良率、并发症发生率采用卡方检验比较。结果两组随访时Harris评分、日常生活能力量表(ADL)评分、生活质量量表(QOL)评分较治疗前增加(对照组:t=10.045、18.185、15.162,均为P<0.05;观察组:t=13.445、23.741、17.324,均为P<0.05)。两组随访时疼痛视觉模拟评分法(VAS评分)较治疗前降低(对照组:t=48.714,P<0.05;观察组:t=78.556,P<0.05)。观察组随访时Harris评分、ADL评分、QOL评分高于对照组(t=5.267、5.205、3.976,均为P<0.05),VAS评分低于对照组(t=8.561,P<0.05),且观察组住院时间、骨折愈合时间更短(t=4.917、4.398,均为P<0.05)。观察组优良率(98.1%)高于对照组(44.2%),并发症发生率(1.9%)低于对照组(13.5%)(2=36.728、4.875,均为P<0.05)。结论生物型翻修加长柄治疗股骨假体松动伴骨缺损的中期随访效果肯定,是一种可行的假体选择方案,远期疗效尚需进一步观察和验证。
Objective To investigate the clinical effect of cementless long-stem hip prosthetic replacement for femoral prosthesis loosening with femoral bone defect.Methods From January 2011 to January 2015,the patients undergoing hip revision procedures in Xinjiang Shaya County People's Hospital were analysed retrospectively.The patients with femoral handle loose,femoral defect and only revision of femoral prosthesis handle were selected.The patients with infection,problem of acetabulum prosthesis,severe medical diseases and osteoporosis were excluded.A total of 104 cases were enrolled.The patients treated by cementless long-stem hip prosthetic were in the observation group(n=52).The patients treated by cement hip prosthetic were in the control group(n=52).The operation time,intraoperative blood loss,hospital stay,fracture healing time and relevant functional scores of the two groups were analyzed by t test.The good rates and incidence of complications were calculated and analyzed by chi-square test.ResultsHarris score,activities of daily living(ADL)score and quality of life(QOL)score were increased in the two groups during the follow-up(control group:t=10.045,18.185,15.162,all P<0.05)(observation group:t=13.445,23.741,17.324,all P<0.05).The visual analogue scale(VAS)scores in the two groups were lower than those before the treatment(control group:t=48.714,P<0.05)(observation group:t=78.556,P<0.05).During follow-up,Harris score,ADL score and QOL score in the observation group were higher than those in the control group(t=5.267,5.205,3.976,all P<0.05),and VAS score was lower than that in the control group(t=8.561,P<0.05).Moreover,the length of hospital stay and fracture healing time in the observation group were shorter(t=4.917,4.398,both P<0.05).The good rate in the observation group(98.1%)was higher than that in the control group(44.2%),and the complication rate in the observation group(1.9%)was lower than that in the control group(13.5%)(2=36.728,4.875,both P<0.05).Conclusion The cementless long-stem hip prosthetic is
作者
李伟
高伟力
周泓宇
Li Wei;Gao Weili;Zhou Hongyu(Department Orthopaedics, Xinjiang Shaya County People′s Hospital, Aksu Prefecture 842000, China;Department Orthopaedics, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Urumuchi 842000, China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2020年第4期417-422,共6页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节成形术
置换
髋
再手术
髋假体
股骨
Arthroplasty
replacement
hip
Reoperation
Hip prosthesis
Femur
