Cieliński Łukasz, Kusz Damian, Wojciechowski Piotr, Dziuba Anna
Katedra i Klinika Ortopedii i Traumatologii Narzadu Ruchu, Slaska Akademia Medyczna, Katowice.
Ortop Traumatol Rehabil. 2007 Mar-Apr;9(2):168-77.
This paper discusses the authors' experience with hip resurfacing arthroplasty. Although introduced many years ago, the method did not gain wide popularity because of poor long-term outcomes. At present, owing to the introduction of metal-on-metal bearings and hybrid fixation techniques, short- and mid-term results are very good and encourage wider use of this technique, especially in the younger and more active patients whose results with standard total hip replacements would be unsatisfactory.
We performed 13 hip resurfacing arthroplasties at our institution between August 1, 2005, and May 1, 2006. Twelve patients reported for the scheduled follow-up and were included in the study. Treatment outcomes were assessed according to the Harris Hip Score.
The short-term outcomes of hip resurfacing arthroplasties are encouraging. In the study group there were no intraoperative complications, infections, peripheral nerve palsy, hip dislocations or clinically overt vein thrombosis. All of the patients reported complete or major pain relief. Clinical assessment according to the Harris Hip Score revealed improvement from an average of 57.7 (20.1) points preoperatively to an average of 87.7 (12) points after the surgery. Crutches were used for a maximum of 6 weeks postoperatively. All of the patients are currently able to walk without crutches with full weight-bearing.
本文讨论了作者在髋关节表面置换术方面的经验。尽管该方法多年前就已引入,但由于长期效果不佳,并未得到广泛应用。目前,由于金属对金属轴承和混合固定技术的引入,短期和中期结果非常好,这鼓励了该技术的更广泛应用,特别是在年轻且活动较多的患者中,这些患者采用标准全髋关节置换术的效果可能不理想。
2005年8月1日至2006年5月1日期间,我们在本机构进行了13例髋关节表面置换术。12例患者前来进行预定的随访,并纳入本研究。根据Harris髋关节评分评估治疗结果。
髋关节表面置换术的短期结果令人鼓舞。研究组术中无并发症、感染、周围神经麻痹、髋关节脱位或明显的临床静脉血栓形成。所有患者均报告疼痛完全缓解或明显减轻。根据Harris髋关节评分进行的临床评估显示,术前平均评分为57.7(20.1)分,术后平均提高至87.7(12)分。术后最多使用拐杖6周。目前所有患者均能不用拐杖完全负重行走。
1)髋关节表面置换术似乎是年轻、活动患者手术治疗的一种可取方法,对于这些患者,标准全髋关节置换术失败风险较高;它可以推迟全髋关节置换术,并在髋臼组件已就位的情况下作为翻修手术进行。2)尽管短期和中期结果良好,但由于缺乏足够的长期随访数据,应谨慎评估该方法的实用性。