| 吕辉,郭江,黄邓华,等.258髋Corail股骨柄假体中期疗效观察.骨科,2020,11(5): 411-416. |
| 258髋Corail股骨柄假体中期疗效观察 |
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| 投稿时间：2020-04-23 |
| DOI：10.3969/j.issn.1674-8573.2020.05.012 |
| 中文关键词: 关节成形术，置换，髋 Corail股骨柄 非骨水泥型假体 羟基磷灰石 保留假体清创术 |
| 英文关键词: Arthroplasty, replacement, hip Corail femoral handle Cementless prosthesis Hydroxyapatite Debridement of retained prosthesis |
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| 中文摘要: |
| 目的 探讨Corail羟基磷灰石全涂层股骨柄假体行全髋关节置换术（total hip arthroplasty, THA）治疗终末期髋关节疾病病人的中期疗效。方法 回顾性分析我院2011年10月至2019年5月采用Corail假体行THA治疗的239例（258髋）终末期髋关节疾病病人的病例资料，其中男137例，女102例，平均年龄为50.4岁（38~79岁）。股骨头缺血性坏死145髋（56.2%），髋关节发育不良58髋（22.4%），髋关节骨性关节炎36髋（14.0%），股骨颈骨折11髋（4.3%），类风湿关节炎8髋（3.1%）。收集病人临床并发症，并采用髋关节Harris评分、疼痛视觉模拟量表（visual analogue scale, VAS）评分评估病人髋关节功能，随访X线片用于跟踪观察假体松动和螺钉断裂情况。结果 术后1例出现肺部感染伴胸腔积液，6例术侧大腿出现不同程度疼痛，5例假体感染，6例脱位，7例小腿肌间静脉血栓，15例假体下沉，未见神经血管损伤等并发症。239例均获随访，随访时间为0.5~7.0年，平均5.8年，末次随访Harris评分为（84.84±5.65）分，VAS评分为（1.11±0.79）分，均较术前显著改善，差异均有统计学意义（t=-98.855，P＜0.001；t=64.593，P＜0.001）。末次随访时股骨柄稳定，未见透亮线迹象，无假体松动，无翻修，股骨柄存活率为100%。结论 采用Corail羟基磷灰石全涂层股骨柄假体行THA具有稳定性持久、术后大腿疼痛发生率较低等优点，中期疗效较好。 |
| 英文摘要: |
| Objective To investigate the medium-term effect of Corail hydroxyapatite (HA) fully coated femoral stem prosthesis for total hip arthroplasty (THA) in patients with end-stage hip disease. Methods The clinical data of 239 patients (258 hips) with end-stage hip disease undergoing THA with Corail prosthesis from October 2011 to May 2019 were analyzed retrospectively, including 137 males and 102 females, aged from 38-79 years (mean 50.4 years). Indications included avascular necrosis of the femoral head in 145 hips (56.2%), hip dysplasia in 58 hips (22.4%), hip osteoarthritis in 36 hips (14.0%), femoral neck fractures in 11 hips (4.3%), and rheumatoid arthritis in 8 hips (3.1%). The clinical complications were collected, and the function of hip joint was evaluated by Harris score, visual analogue scale (VAS). Follow-up X-ray was used to observe the loosening of the prosthesis and the fracture of the screw. Results After operation, 1 patient developed pulmonary infection with pleural effusion, 6 patients had varying degrees of pain in the thigh, 5 patients had prosthesis infection, 6 patients had dislocation after operation, 7 patients had intermuscular vein thrombosis of leg after operation, 15 patients had prosthesis subsidence after operation, and there was no complications such as neurovascular injury. All 239 cases were followed up for 0.5-7.0 years (mean 5.8 years). The Harris score and VAS score of the last follow-up were 84.84±5.65 and 1.11±0.79 respectively, both of which were significantly improved as compared with those preoperation, and the differences were statistically significant (t=-98.855, P＜0.001; t=64.593, P＜0.001). All the femoral stalks were very stable and there was no sign of transparent line, no prosthesis loosening and revision, and the survival rate of the femoral stem was 100%. Conclusion Corail HA fully coated femoral stem prosthesis has the advantages of long-term stability, low incidence of postoperative thigh pain and good mid-term effect. |
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