Zhang Xiao-bin, Song Jin-hui, Wang Kun-zheng
Department of Orthopaedics, Second Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P. R. China 710004.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2004 Mar;18(2):135-7.
To evaluate the selection of the type of prosthesis in revision hip arthroplasty.
There were 33 hips in our study, male in 7 hips and female in 26 hips. The average age of the patients were 59 years. The reasons of the revision included aseptic loosing in 22 hips, infection in 8 hips (2 infection hips with discharging sinuses), and acetabular erosion in 3 hips. The operations for revision were 13 cemented and 12 cementless acetabular prosthesis with autograft in morselized form; the femoral revision were all selected in cemented prosthesis. The revision for infection hip were all cemented prosthesis of extensively porouse-coated.
The average follow-up duartion was 3.9 years and 11 months. There was a radiolucency but no clinical instability accompanied in 2 hips and remaining moderate pain in 4 hips. No dislocation and fracture were seen in the series. Harris score were improved to 82.4 (68-88).
The commonest reason of revision hip arthroplasty was aseptic loosing. The acetabular prosthesis in revision could select cemented or cementless components and femoral prosthesis could select extensively coated stem. The cemented components could yield good results in infection hips revision.
评估髋关节翻修术中假体类型的选择。
本研究共纳入33例髋关节，其中男性7例，女性26例。患者平均年龄59岁。翻修原因包括无菌性松动22例，感染8例（2例感染伴有窦道形成），髋臼磨损3例。髋臼翻修采用骨水泥型13例，非骨水泥型12例并采用颗粒状自体骨移植；股骨翻修均选用骨水泥型假体。感染性髋关节翻修均采用广泛多孔涂层的骨水泥型假体。
平均随访时间为3年11个月。2例出现透亮线但无临床不稳定，4例仍有中度疼痛。该组病例未出现脱位及骨折。Harris评分提高至82.4（68 - 88）。
髋关节翻修术最常见的原因是无菌性松动。髋臼假体翻修可选择骨水泥型或非骨水泥型，股骨假体可选择广泛涂层柄。骨水泥型假体在感染性髋关节翻修中可取得良好效果。
