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[1]許楊,凌義龍,韋金忠,等.長柄全涂層表面微孔股骨假體在人工全髖關節(jié)翻修術(shù)中的應用[J].中醫(yī)正骨,2016,28(09):49-51.
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長柄全涂層表面微孔股骨假體在人工全髖關節(jié)翻修術(shù)中的應用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年09期
頁碼:
49-51
欄目:
臨床報道
出版日期:
2016-09-20

文章信息/Info

作者:
許楊凌義龍韋金忠魏平洋劉磊夏炳江錢淼忠
浙江省紹興市中醫(yī)院,浙江 紹興 312000
關鍵詞:
髖假體 關節(jié)成形術(shù)置換 假體失效 假體周圍骨折 假體相關感染 再手術(shù)
摘要:
目的:觀察長柄全涂層表面微孔股骨假體用于人工全髖關節(jié)翻修術(shù)的臨床療效及安全性。方法:2010年1月至2015年12月,采用長柄全涂層表面微孔股骨假體對曾經(jīng)接受人工全髖關節(jié)置換術(shù)的16例患者行翻修手術(shù),男7例、女9例。年齡47~86歲,中位數(shù)61歲。均為初次行翻修術(shù)的患者。左側(cè)9例,右側(cè)7例。髖關節(jié)翻修原因,假體無菌性松動12例,其中單純股骨側(cè)假體松動5例、股骨側(cè)合并髖臼側(cè)假體松動4例、單純髖臼側(cè)假體松動3例; 股骨側(cè)假體無菌性松動合并股骨假體周圍骨折2例; 人工全髖關節(jié)置換術(shù)后感染2例。股骨側(cè)骨缺損程度按照Paprosky分型標準,Ⅰ型12例、Ⅱ型4例。初次行人工全髖關節(jié)置換術(shù)至本次翻修手術(shù)間隔時間為3.5~19年,中位數(shù)9.6年。隨訪觀察股骨假體穩(wěn)定性、髖關節(jié)活動度及功能、雙下肢不等長距離及并發(fā)癥發(fā)生情況。結(jié)果:所有患者均獲隨訪,隨訪時間6個月至5年,中位數(shù)2.5年。股骨假體穩(wěn)定性良好,獲得骨長入固定14例、穩(wěn)定的纖維固定2例。所有患者均未出現(xiàn)假體松動及感染。1例術(shù)中股骨干骨折,采用鋼板及螺釘固定,并延期負重活動。2例股骨假體下沉<5 mm,但無明顯臨床癥狀。翻修術(shù)后2周,Harris髖關節(jié)功能評分較術(shù)前增高[(43.1±8.2)分,(85.2±11.8)分,t=9.909,P=0.000]。翻修術(shù)后5個月,髖關節(jié)屈曲、伸直、外展及外旋活動度均較術(shù)前改善[(45.0°±10.9°),(102.6°±18.2°),t=8.612,P=0.000;(-6.9°±2.0°),(2.9°±1.2°),t=13.622,P=0.000;(14.8°±3.7°),(33.2°±5.3°),t=8.854,P=0.000;(13.1°±4.0°),(28.2°±6.4°),t=6.781,P=0.000],雙下肢不等長距離短于術(shù)前[(2.1±0.4)cm,(0.9±0.3)cm,t=7.348,P=0.000]。結(jié)論:采用長柄全涂層表面微孔股骨假體行人工全髖關節(jié)翻修術(shù),假體穩(wěn)定性高、髖關節(jié)功能及活動度恢復良好、并發(fā)癥少,值得臨床推廣應用。

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備注/Memo

備注/Memo:
2016-06-03收稿 2016-07-19修回

更新日期/Last Update: 1900-01-01