【作者】 赵杰；

【导师】 吴立东；

【作者基本信息】 浙江大学 ， 外科学， 2010， 硕士

【摘要】 目的探讨金属对金属大直径股骨头全髋关节置换术(total hip replacement, THR)的近期疗效,及其在中青年人群与老年人群中的近期随访有无显著差异。方法回顾性分析2009年3月至2009年5月行金属对金属大直径股骨头THR全部患者32例(32髋),男20例20髋,女12例12髋；年龄31～78岁,平均57岁,其中年龄≤55周岁组14例(14髋),年龄≥60周岁组18例(18髋)。原发疾病中,股骨头坏死12例12髋,强直性脊柱炎髋关节病变5例5髋,股骨颈骨折5例5髋,髋臼发育不良继发骨关节炎10例10髋。对其进行临床功能及并发症评估,并对两组相互比较。结果32例患者随访时间10.6～12.2个月,平均11.5个月。术中无一例出现骨折、神经麻痹、血管损伤等并发症,术后亦未发生脱位、假体松动及深静脉血栓等并发症,所有患者下肢长度的差异<1cm。Harris评分由术前的23～48分,平均(39.5±4.7)分提高至术后随访时的78～95分,平均(89.4±9.3)分,有显著提高,髋关节活动度提高显著。年龄≤55周岁组由平均(37.9±5.3)分提高至术后随访时的平均(90.3±8.9)分,年龄≥60周岁组由平均(40.1±4.5)分提高至术后随访时的平均(88.7±11.4)分,经统计学处理均无显著差异,且两组无显著差异。结论采用金属对金属大直径股骨头THR治疗股骨头坏死、强直性脊柱炎导致的髋关节炎和髋臼发育不良的年轻或较大活动量的患者近期疗效良好,且在中青年人群与老年人群中的近期随访有无显著差异,而中长期临床结果仍有待进一步研究。更多还原

【Abstract】 Objective To explore the key operation techniques, postoperative early rehabilitation, indications and short-term results of total hip replacement(THR) using large diameter heads(LDH)in metal-on-metal(MOM)articulation. We try to find the result in different age groups by this approach.Methods:A consecutive series of 32 patients(32 hips)who underwent THR using ASR LDH in MOM articulation from March 2009 to May 2009 were studied. There were 20 men and 12 women with a mean age of 57 years(range,31-78years). The 32 patients were divided into two groups:the first group was consist of 14 patients(14 hips), and the other of 18 patients(18 hips).Results:No intraoperative complications such as intraoperative fracture, nerve palsy, or vascular injury was observed. There was no dislocation or deep vein thrombosis postoperatively. In all patients, leg length discrepancy was within 10mm difference. The average Harris hip score at the last follow-up was significantly improved compared with the preoperative (89.4 points versus 39.5 points). The average range of motion(ROM)of hips at the last follow-up was significantly improved compared with the preoperative values. Statistically significant differences were not found between the two groups.Conclusion:The short-term results of LDH in MOM total hip replacement on ANFH, osteoarthritis, rheumatoid arthritis, femur neck fracture, osteoarthritis secondary to dysplastic hips, ankylosing arthritis are excellent.更多还原