金对金髋关节置换失败伴炎性假瘤患者翻修预后的影响因素

发布时间：2018-10-22 17:16

【摘要】：背景:经查阅文献发现,炎性假瘤引起的髋关节置换翻修术相关的研究较少。目的:旨在随访观察金对金髋关节置换失败伴有炎性假瘤患者翻修术后预后情况,并分析其翻修术后预后的影响因素。方法:收集81例拟行髋关节置换翻修术患者既往医疗记录、基线资料及初次置换手术信息,完善术前检查行翻修术后,利用HSS评分评估术后关节功能,行影像学检查评估假体情况,测定血清钴铬离子浓度,统计术后并发症发生情况,统计分析并发症的影响因素。结果与结论:(1)患者翻修术后关节评分显著上升(P=0.000);血清钴铬离子浓度显著下降(P=0.000);(2)翻修术后并发症发生率为16%,术后再翻修率为6%;(3)术前假体松动(P=0.012)、MRI检查提示组织硬化(P=0.000)、术中组织损伤分级较高(P=0.049)等因素与翻修术后并发症相关;(4)KM生存曲线提示术后30个月时假体存活率为88%;(5)结果提示,金对金髋关节置换失败患者翻修术后总体预后较差,预后危险因素包括术前无菌性松动、关节周围组织硬化、翻修术中组织损伤分级。预后不良危险因素的确认对于临床医师确定翻修手术方案具有指导作用。
[Abstract]:Background: few studies have been conducted on hip arthroplasty due to inflammatory pseudotumor. Objective: to observe the prognosis of patients with failed hip replacement associated with inflammatory pseudotumor after revision and to analyze the prognostic factors. Methods: previous medical records, baseline data and information of primary replacement were collected in 81 patients with hip arthroplasty. The postoperative joint function was evaluated by HSS score. Imaging examination was performed to evaluate the prosthesis, to determine the serum cobalt and chromium ion concentration, to calculate the incidence of postoperative complications, and to analyze the influencing factors of complications. Results and conclusion: (1) the joint score increased significantly after revision (P0. 000), the serum cobalt-chromium ion concentration decreased significantly (P0. 000); (2), the incidence of complications after revision was 16 and the rerevision rate was 6. (3) the preoperative prosthesis loosening (P0. 012), MRI) showed tissue sclerosis (P0. 000). The higher grade of intraoperative tissue injury (P0. 049) was associated with the complications after revision, (4) the survival rate of prosthesis was 88% at 30 months after operation according to KM survival curve, and (5) the results suggested that the survival rate of the prosthesis was 88% at 30 months after operation. The overall prognosis of the patients after revision was poor. The prognostic risk factors included preoperative aseptic loosening, periarticular tissue sclerosis, and grade of tissue injury during revision. The identification of risk factors for poor prognosis is useful for clinicians to determine the revision procedure.
【作者单位】：西南医科大学附属医院骨科;射洪县中医院骨科;四川省人民医院骨科;
【分类号】：R687.4

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