人工全髋关节置换术假体松动原因的回顾性研究

发布时间：2018-03-26 03:56

本文选题：髋关节　切入点：置换手术　出处：《中国地方病防治杂志》2017年01期

【摘要】：目的探讨髋关节置换术假体松动失败的原因及机制。方法收集我院2009年8月~2011年8月共15例髋关节置换术后初次失败病例,其中无菌性松动13髋(其中股骨假体柄松动合并髋臼假体松动4例,股骨假体柄松动4例,髋臼假体松动5例),感染性松动2例,全部15例均行翻修术,其中4例行全髋翻修、4例柄侧翻修、5例行髋臼翻修,感染性松动行抗生素骨水泥占位控制感染后二期翻修。结果 13例行翻修术者术后伤口均一期愈合,2例感染患者在感染控制后均行全髋翻修。随访10~36月(平均20.60±7.06月)无松动及感染,在最后一次随访中,本组病例的Harris评分为56~93(平均79.60±11.90)分,其中优4例,良7例,可1例,差3例,优良率为73.3%。结论本组全髋关节置换假体松动发生机理涉及手术技巧、假体类型、髋臼假体位置、股骨截骨长度及外展肌力量。
[Abstract]:Objective to investigate the causes and mechanism of loosening of hip prosthesis in our hospital from August 2009 to August 2011. Among them, 13 hips were aseptic loosening (including 4 cases of femoral prosthesis loosening with acetabular loosening, 4 cases of femoral prosthesis loosening, 5 cases of acetabular loosening, 2 cases of infective loosening, all 15 cases underwent revision operation. Among them, 4 cases had total hip revision, 4 cases had lateral pedicle revision, 5 cases had acetabular revision. The infection loosening was carried out after the second stage revision after infection controlled by antibiotic bone cement. Results all the 13 patients underwent primary wound healing and 2 patients with infection underwent total hip revision after infection control. The follow-up was from 10 to 36 months (mean 20.60 卤7.06). No loosening and infection, At the last follow-up, the Harris score of this group was 560.93 (mean 79.60 卤11.90), including excellent 4 cases, good 7 cases, fair 1 case, poor 3 cases, excellent and good rate was 73.3%. Conclusion the mechanism of total hip replacement prosthesis loosening involves surgical techniques, prosthesis type, and so on. Position of acetabular prosthesis, length of femur osteotomy and strength of abductor muscle.
【作者单位】：浙江省嘉兴市第一医院骨科;吉林大学第二医院骨科;吉林大学第一医院放疗科;
【分类号】：R687.4

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