应用金属对金属全髋表面置换术的早期疗效及临床体会

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1、应用金属对金属全髋表面置换术的早期疗效及临床体会作者：茹江英　胡玉华　刘璠　王长峰　兰海峰【摘要】　　［目的］探讨金属对金属人工全髋表面置换术的早期疗效及临床体会，指导临床规范、合理的应用该技术。［方法］从XX年9月～XX年7月，对18例患者行混合型MMSA术，其中股骨头坏死12例、骨性关节炎3例、先天性髋关节发育不良2例和创伤后骨性关节炎1例。平均年龄43岁，平均体重指数。对所有患者都进行了问卷调查、髋关节功能检查、并做了术前、术后的Harris评分，术后疼痛发生评估及X线分析等。［结果］所有患者均获得随访，平均随访个月。23个患髋的Harris髋关节评分平均从术前46分到术后

2、1年的85分，最后一次随访时为93分。2例术后轻微疼痛，1例中度疼痛，无严重疼痛报告。X线显示：1例股骨假体内翻成角10°，但随访过程中没有出现假体松动和股骨颈骨折的并发症。所有病例未发现有股骨颈狭窄、股骨头坏死及假体固定失败等并发症。［结论］作为THR术前的过渡性术式，MMSA术为治疗年轻的或术后对活动量要求较高的年老髋关节疾病患者提供了一种新的有价值的手术方法。其早期疗效令人满意，但中、长期临床结果仍需进一步研究。【关键词】人工全髋表面置换术金属对金属髋关节体会Shorttermresultandclinicalcomprehensiononapplicationofmet

3、alonmetalsurfacereplacementofhip∥　　Abstract：［Objective］Toapproachtheshorttermresultofmetalonmetalsurfacearthroplasty(MMSA)andclinicalcomprehensiontodirectitsstandardandreasonableapplicationclinically.［Method］FromSeptember,200toJuly,XX,2hipsin1patientsweretreatedwithhybridprothesisofMMSAinclu

4、ding1caseofosteonecrosis(ON),casesofosteoarthritis(OA),1casesofdevelopmentaldysplasiaofthehip(DDH)and1caseofposteriortraumaarthritis(PTA).ThemeanagewasyearsandtheaverageRMIpatientswereevaluatedbyselfassessmentform,hipfunctionexamination,radiographs,occurrenceofpain,preoperativeandpostoperativ

5、eHarrishipscore.［Result］AllpatientsobtainedthefollowupandtheaveragetimewasHarrisscorerosefrompreoperative(32～51）to5atoneyearaftertheoperationto3atthelatestfollow1hips,hipshadmildpain,1hiphadmoderatepain,andnopatientsreportedmarked,1femoralcomponentshadintroversionangulationof10°,butprosthes

6、islooseningandfracturesoffemoralneckhadnothappenedatthelatestfollowwasnooccuranceofcomplicationssuchasfemoralnecknarrowing,osteonecrosisandfailureoffixiationetcinallpatients.［Conclusion］Asatransitionaloperationbeforeapplyingthetotalhipreplacement(THR),MMSAoffersanewlyvaluabletechnologyfortre

7、atmentofyoungpatientsortheelderlypatientswiththehigherrequirementofmovementaftertheshorttermresultissatisfactory,butthemediumandlongtermeffectionstillneedthefurtherresearch.　　Keywords：totalhipsurfacereplacement;metalonmetalbearings;hipjoint