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[1]駱曉飛,王金良,王少華,等.金屬墊塊修復(fù)PaproskyⅢ型髖臼骨缺損在人工髖關(guān)節(jié)翻修術(shù)中的應(yīng)用[J].中醫(yī)正骨,2020,32(07):43-46.
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金屬墊塊修復(fù)PaproskyⅢ型髖臼骨缺損在人工髖關(guān)節(jié)翻修術(shù)中的應(yīng)用()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年07期
頁碼:
43-46
欄目:
臨床報道
出版日期:
2020-07-20

文章信息/Info

作者:
駱曉飛王金良王少華蔡松濤孫京濤魏瑄
鄭州市骨科醫(yī)院,河南 鄭州 450052
關(guān)鍵詞:
關(guān)節(jié)成形術(shù)置換 再手術(shù) 髖臼 骨缺損 金屬墊塊
摘要:
目的:觀察人工髖關(guān)節(jié)翻修術(shù)中應(yīng)用金屬墊塊修復(fù)PaproskyⅢ型髖臼骨缺損的臨床療效與安全性。方法:2016年1月至2018年11月,采用人工髖關(guān)節(jié)翻修術(shù)治療初次全髖關(guān)節(jié)置換術(shù)(total hip arthroplasty,THA)后假體無菌性松動患者34例,術(shù)中均采用金屬墊塊修復(fù)髖臼骨缺損。男21例,女13例。年齡53~84歲,中位數(shù)68.5歲。左側(cè)19例,右側(cè)15例。髖臼骨缺損根據(jù)Paprosky分型,ⅢA型28例、ⅢB型6例。初次THA距本次翻修手術(shù)時間6~16年,中位數(shù)8年。記錄手術(shù)時間、術(shù)中出血量。采用Harris髖關(guān)節(jié)評分、視覺模擬量表(visual analogue scale,VAS)評分評價臨床療效。測量術(shù)前與術(shù)后1年髖臼中心的垂直距離與水平距離。觀察治療及隨訪期間并發(fā)癥發(fā)生情況。結(jié)果:34例患者手術(shù)均順利完成,手術(shù)時間(141.88±9.14)min,術(shù)中出血量(571.88±60.91)mL。單純髖臼翻修12例,全髖關(guān)節(jié)翻修22例。所有患者均獲隨訪,隨訪時間12~45個月,中位數(shù)26個月。Harris髖關(guān)節(jié)評分,術(shù)前(46.55±10.28)分、術(shù)后3個月(65.71±11.25)分、術(shù)后6個月(76.04±9.35)分、術(shù)后1年(84.19±6.81)分。髖關(guān)節(jié)疼痛VAS評分,術(shù)前(4.11±1.04)分、術(shù)后3個月(1.05±0.21)分、術(shù)后6個月(0.94±0.17)分、術(shù)后1年(1.02±0.24)分。髖臼中心垂直距離,患側(cè)術(shù)前(33.68±4.19)mm、術(shù)后1年(23.31±2.17)mm,健側(cè)(15.31±2.24)mm,患側(cè)術(shù)后1年較健側(cè)上移(8.27±2.65)mm; 髖臼中心水平距離,患側(cè)術(shù)前(26.47±3.92)mm、術(shù)后1年(33.01±3.15)mm,健側(cè)(33.46±1.97)mm。末次隨訪時,金屬墊塊與骨面緊密接觸,骨長入良好; 均未發(fā)生金屬墊塊移位、螺釘斷裂、骨溶解、感染及假體周圍骨折等并發(fā)癥。結(jié)論:人工髖關(guān)節(jié)翻修術(shù)中采用金屬墊塊修復(fù)PaproskyⅢ型髖臼骨缺損,能夠恢復(fù)髖關(guān)節(jié)解剖結(jié)構(gòu),改善髖關(guān)節(jié)功能,且安全性高。

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備注/Memo

備注/Memo:
基金項目:河南省科技攻關(guān)計劃項目(182102310690); 河南省中醫(yī)藥科學(xué)研究專項課題(2017ZY3010) 通訊作者:魏瑄 E-mail:[email protected]
更新日期/Last Update: 2020-07-20