Accolade TMZF生物型股骨假体用于全髋置换术的早期疗效研究

发布时间：2018-11-25 08:43

【摘要】：目的观察Accolade TMZF生物型股骨柄假体在全髋置换术的近期疗效与并发症。方法回顾性研究我科2010年2月至2012年7月期间采用Accolade TMZF生物型股骨假体初次行全髋关节置换的67例70髋病例的疗效,男25例,女42例。年龄39岁~82岁,平均62.1岁。左髋31例,右髋33例,双髋3例。术前诊断:股骨颈骨折31例31髋,股骨头缺血性坏死19例21髋,发育不良性髋关节炎7例8髋,髋关节骨性关节炎4例4髋,创伤性关节炎4例4髋,类风湿性关节炎1例1髋,髋关节结核1例1髋。本组病例均采用Accolade TMZF生物型髋关节假体系统,股骨侧假体使用同一款Accolade TMZF生物锥形柄,髋臼侧则采用Secure-fit HA和Trident PSL HA两种髋臼杯行生物学固定。关节头臼摩擦面采用陶瓷-陶瓷组合49髋,陶瓷-聚乙烯组合19髋,金属-聚乙烯组合2髋。结果全部病例随访均超过2年以上,平均39个月(24-53个月)。术前Harris髋关节评分平均(32.7±6.2)改善至末次随访时(89.2±5.1)。末次随访时大腿轻度疼痛4例(5.7%),无中重度、极重度疼痛。无一患髋因各种原因失败需行翻修术。X线片表现:最终随访时无假体移位或松动现象,股骨侧可见假体周围均为骨性固定,假体下沉2mm者1髋,其余均无假体下沉。并发症:术中无血管、神经损伤;术中因扩髓造成股骨距劈裂骨折而采用钢丝环扎4髋。术后无下肢深静脉血栓形成,无假体周围骨折。结论Accolade TMZF生物型股骨假体用于初次全髋置换术的早期疗效满意,可以有效改善髋关节功能,减轻患者髋部疼痛,恢复行走功能。但是随访时间较短,中远期疗效将进一步观察。
[Abstract]:Objective to observe the short-term curative effect and complications of Accolade TMZF biological prosthesis of femur handle in total hip replacement. Methods from February 2010 to July 2012, 67 cases (25 males and 42 females) underwent total hip arthroplasty (THR) with Accolade TMZF biological prosthesis were retrospectively studied. The age ranged from 39 to 82 years (mean 62.1 years). Left hip 31 cases, right hip 33 cases, double hip 3 cases. Preoperative diagnosis included femoral neck fracture (31 hips), avascular necrosis of femoral head (19 cases, 21 hips), dysplastic hip arthritis (7 cases, 8 hips), hip osteoarthritis (4 cases, 4 hips), traumatic arthritis (4 cases, 4 hips). Rheumatoid arthritis (1 hip) and hip tuberculosis (1 hip). All the patients were treated with Accolade TMZF biotype hip prosthesis system. The femoral side prosthesis used the same Accolade TMZF bioconical stalk, and the acetabular side was biologically fixed with two kinds of acetabular cup (Secure-fit HA and Trident PSL HA). The friction surface of the joint was composed of 49 hips of ceramic and ceramics, 19 hips of ceramic to polyethylene and 2 hips of metal to polyethylene. Results all cases were followed up for more than 2 years, with an average of 39 months (24-53 months). Preoperative Harris hip score was improved from (32.7 卤6.2) to (89.2 卤5.1) at the last follow-up. At the last follow-up, 4 cases (5.7%) had mild thigh pain without moderate or severe pain. The X-ray findings showed that there was no displacement or loosening of the prosthesis at the end of follow-up. Bone fixation was seen around the prosthesis on the femur side. 1 hip was found to sink the prosthesis in 2mm, and no prosthetic sinking was found in the rest. Complications: no injury of blood vessel and nerve, 4 hips of femoral talus fracture caused by reaming. There was no deep vein thrombosis and no periprosthetic fracture. Conclusion the early curative effect of Accolade TMZF biological femoral prosthesis for primary total hip replacement is satisfactory. It can effectively improve hip joint function, relieve hip pain and restore walking function. But follow up time is shorter, medium and long-term curative effect will observe further.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4

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