摘要目的 本研究观察生物型股骨柄应用于全髋关节置换术(total hip arthroplasty,THA)的临床效果,并探究影像学上生物型股骨柄的沉降情况。方法 纳入2019年10月至2020年10月在西安交通大学附属红会医院关节中心行THA的124例患者(136髋),其中男性56髋,女性80髋;平均年龄(53.0±12.5)岁,收集纳入研究病例的术前及术后随访时的疼痛视觉模拟评分(visual analog scale,VAS)、Harris髋关节功能评分(Harris hip score,HHS)、生存质量评分(12 item short form health survey,SF-12)、伤口愈合情况、假体松动、感染及翻修等并发症的发生率;术后第1天、1个月、3个月、6个月、1年随访时分别拍摄骨盆正位X线片,并测量股骨柄沉降数据。结果 术后1个月、3个月、6个月、1年随访时VAS、HSS及SF-12评分均较术前明显改善,且VAS评分在术后3个月以后无显著变化,HHS评分术后6个月以后无显著变化,SF-12在术后1年内呈逐渐提高趋势。术后1个月时有2例伤口浅表愈合不佳,给予清创缝合后均愈合,术后1年随访期间内,未发生假体松动、感染等并发症。术后3个月内生物型股骨柄有沉降发生,其中术后1个月平均沉降(0.46±2.63) mm,术后3个月沉降(1.15±2.77) mm,3个月后未再发生假体下沉。结论 生物型股骨柄在THA术中应用可以获得良好的临床效果,生物型股骨柄在术后前3个月内确有沉降发生,但沉降量不会增加早期手术失败风险。
Abstract:Objective To observe the clinical effect and migration of the cementless femoral stem after total hip arthroplasty (THA) .Methods A total of 124 patients (136 hips) who underwent THA at the Joint Center of Honghui Hospital from October 2019 to October 2020 were included.There were 56 hips in males and 80 hips in females,and the mean age was (53.0±12.5) years.Visual analog scale(VAS),harris hip score (HHS),12-item short form health survey(SF-12) were mainly observed before operation and after operation.Wound healing status,and complications such as prosthesis loosening,infection,and the revision rate were also collected.X-ray examination of the pelvis was performed on the 1st day,1 month,3 months,6 months and 1 year after operation,and the migration of the femoral stem were measured.Results VAS,HHS and SF-12 were significantly improved at 1 month,3 months,6 months and 1 year after surgery than before.VAS stopped to improve from 3 months and HHS stopped to improve from 6 months after surgery,and SF-12 showed a trend of gradual improvement within 1 year after surgery.Poor superficial wound healing was happened in 2 cases at 1 month,which healed after debridement and suturing.There were no prosthesis loosening,infection and other patients requiring revision surgery in the 1-year follow-up.The migration of the cementless femoral stem was indeed occurred within 3 months after the operation.The average migration was (0.46±2.63) mm at 1 month and (1.15±2.77) mm at 3 months,and there was no migration after 3 months.Conclusion The application of cementless femoral stem in total hip arthroplasty can obtain good clinical results.And the migration was observed in the first 3 months after surgery,but the amount of migration does not increase the risk of early failure.
王波,郭达,彭侃,郝阳泉,许鹏,冯磊. 全髋关节置换术中生物型股骨柄沉降的应用研究[J]. 实用骨科杂志, 2023, 29(3): 208-.
Wang Bo,Guo Da,Peng Kan,Hao Yangquan,Xu Peng,Feng Lei. Application Study of The Subsidence of Cementless Femoral Stem on Total Hip Arthroplasty. sygkzz, 2023, 29(3): 208-.
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