| 杨忠,刘科保,李军,等.非骨水泥型Spotorno股骨柄假体在全髋关节置换术中应用的中远期疗效观察.骨科,2021,12(5): 445-450. |
| 非骨水泥型Spotorno股骨柄假体在全髋关节置换术中应用的中远期疗效观察 |
| Medium- and Long-Term Effectiveness of Cementless Spotorno Femoral Stem Prosthesis in Total Hip Arthroplasty |
| 投稿时间：2020-10-06 |
| DOI：10.3969/j.issn.1674-8573.2021.05.011 |
| 中文关键词: 关节成形术，置换，髋 股骨柄 非骨水泥型假体 |
| 英文关键词: Arthroplasty, replacement, hip Femoral stem Cementless prosthesis |
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| 中文摘要: |
| 目的 探讨采用非骨水泥型Spotorno（CLS）股骨柄假体行初次全髋关节置换术（total hip arthroplasty，THA）的中远期疗效。方法 回顾性分析2013年5月至2015年8月我科采用CLS股骨柄假体行THA手术治疗的78例病人的临床资料，其中男45例（48髋），女33例（38髋），年龄为43~81岁，平均61.3岁。术前诊断为股骨头无菌性坏死39例（39髋），髋关节发育不良28例（36髋），股骨颈骨折7例（7髋），类风湿性关节炎4例（4髋）。术前髋关节Harris评分为（52.10±3.35）分。术后定期随访，复查骨盆X线片，评估是否出现假体下沉、松动、移位等相关并发症，比较手术前后的髋关节Harris评分。结果 所有病例均顺利完成手术，术中有3例病人出现股骨距劈裂骨折，采用钢缆环扎后，未见假体松动；2例术后切口出现愈合不佳，经换药后伤口一期愈合。本组病例随访5~7年，平均6.4年。末次随访的Harris评分为（92.39±6.61）分，与术前对比，差异有统计学意义（P＜0.05）。随访期间有2例出现了大腿轻度疼痛，1例出现假体周围骨折，未见无菌性松动、神经血管损伤、脱位等并发症，2例（2髋）出现慢性低毒性假体感染并行髋关节二期翻修术，股骨柄远期生存率为97.7%。结论 CLS股骨柄假体应用于初次THA，可获得良好的假体初始稳定性，髋关节功能改善明显，中远期疗效满意。 |
| 英文摘要: |
| Objective To investigate the medium- and long-term effectiveness of total hip arthroplasty (THA) in total hip arthroplasty with Cementless Spotorno (CLS) stem prosthesis. Methods The clinical data of 78 patients who underwent total hip arthroplasty with CLS femoral stem prosthesis in our department from May 2013 to August 2015 were analyzed retrospectively, including 45 males (48 hips) and 33 females (38 hips), aged from 43 to 81 years (mean 61.3 years). Preoperative diagnosis included aseptic necrosis of the femoral head in 39 cases (39 hips), hip dysplasia in 28 cases (36 hips), femoral neck fracture in 7 cases (7 hips) and rheumatoid arthritis in 4 cases (4 hips). The preoperative Harris score was 52.10±3.35. Regular clinical follow-up and pelvic X-ray examination were performed to evaluate the related complications such as subsidence, loosening and displacement of the prosthesis. Moreover, the comparison of Harris score of hip pre-operation and the final follow-up was also performed. Results All the operations were successfully completed. Among them, during the operation, there were 3 patients with split fracture of femur, and there was no prosthesis loosening after steel cable encircling. Two cases had poor wound healing after operation, and the wound healed in the first stage type I after dressing change. All cases were followed up with an average period of 6.4 years (5-7 years). The Harris score of the last follow-up was 92.39±6.61, which was significantly different from that before operation (P＜0.05). During the follow-up period, 2 patients had mild thigh pain, 1 patient had periprosthetic fracture, no patient had complications such as aseptic loosening, neurovascular injury and dislocation, and 2 patients (2 hips) had chronic low toxic prosthesis infection and two-stage revision hip arthroplasty. The long-term survival rate of CLS was 97.7%. Conclusion When the CLS femoral stem prosthesis is used in the primary THA, a good initial stability of the prosthesis can be obtained. The medium-and long-term effect of CLS femoral stem prosthesis is satisfactory. |
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