【摘要】 目的评价初次全髋关节置换(THA)术后6年以上的临床疗效及术后的各种并发症。方法自2001年1月至2005年1月,本中心共对北京地区210例225侧髋关节进行初次THA。其中单侧髋关节置换术195例,双髋同时置换术15例。半髋置换10例,全髋关节置换术215例。骨水泥固定假体18例,非骨水泥固定假体207例。围手术期及术后处理基本一致。术后定期随访,最新的随访时间平均为6.5年(5.5~8.5年)。结果围手术期并发症包括:术中股骨干骨折6例;下肢深静脉血栓28例,无肺栓塞病例;术后伤口感染4例;术后4周内脱位3例;术后出现一过性意识障碍3例。术后平均6.5年时176例183髋得到随访,34例42髋失访。远期感染病例1例,脱位2例,股骨干骨折4例。Harris评分由术前平均40.6分(-12~59分)提高到术后平均80.4分(75~94分)。其中152例评分>80分,19例评分位于70~80分之间,5例评分<70分。影像学检查3例髋臼假体、4例6髋股骨假体周围出现小范围的透亮线,2例3髋发现位于髋关节周围的异位骨化。其余X线片示髋臼和股骨柄假体位置满意,无松动和感染征象。结论 THA是治疗各种晚期重度髋关节疾病很好的方法,6年以上的临床效果良好,并发症少。更多还原

【Abstract】 Objective To evaluate the clinical results and complications of primary total hip arthroplasty(THA) over six years.Methods Between January 2001 to January 2005,225 primary total hip arthroplasties were peformed in 210 consecutive patients in Beijing.There were 195 unilateral and 15 bilateral total hip arthroplasties,10 hemiarthroplasties and 215 total arthroplasties.Eighteen hips were fixed with cement and 207 hips were cementless fixation.Peri-operative and postoperative treatments of patients were similar.Regular follow-up was carried out after operation.The mean follow-up period was 6.5 years(5.5-8.5 yr).Results There were some peri-operative complications including six cases of femoral fracture,28 cases of deep venous thrombosis of lower extremity without pulmonary embolism,four cases of wound infection,three dislocations four weeks after operation,three cases of transient disorder of consciousness.After 6.5 years in average,34 patients(42 hips) were lost for follow-up,and 176 patients(183 hips) were still available for clinical and radiographical follow-up.Longterm complications included one postoperative infection,two dislocations,four femoral fractures.The average Harris Hip Score increased from 40.6 points(-12 to 59 points) preoperatively to 80.4 points(75 to 94 points) at the final follow-up(152 cases over 80 points,19 cases between 70 and 80 points,five cases below 70 points).Radiographic analysis showed: small range of lucent line around the cup(three cases) and the femoral stem(four cases,six hips);ectopic ossification around hip joint in two patients(three hips).The stem position and the cup position were set with no evidence of prosthetic loosening or infection in other patients.Conclusion The results suggest that THA may be suitable to treat all kinds of severe diseases of hip joint,which has good clinical outcomes with less complications in this over-6-year follow-up.更多还原