García-Ramiro S, Cofán F, Esteban P L, Riba J, Gallart X, Oppenheimer F, Campistol J M, Suso S
Department of Orthopaedic and Trauma Surgery, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain.
Hip Int. 2008 Jan-Mar;18(1):51-7. doi: 10.1177/112070000801800110.
Osteoarticular complications are common in patients with chronic renal failure and they often require implantation of a hip arthroplasty (total or partial) due to osteoarthritis, femoral neck fracture or ischemic necrosis of multifactor aetiology. Between 1992 and 2005 we operated on eighteen patients (23 hips) with chronic renal failure who were receiving renal replacement therapy (ten haemodialysis and eight renal transplants), and in each case either a total or partial hip arthroplasty was implanted. This group comprised nine women and nine men, with a mean age of 56 years (range: 30-83). Five cases were bilateral. The clinical diagnoses were necrosis (fourteen cases), femoral neck fracture (five cases) and osteoarthritis (three cases). The main early complications were haemorrhage in seventeen cases (74%) and infection in six cases (33%) (two urinary infections and four of the surgical wound). The late complications involved eight cases (35%) of prosthetic loosening (five aseptic and three septic). The surgery-related mortality rate was 17% (three cases). Prosthetic hip surgery in patients receiving renal replacement therapy is associated with high morbidity and mortality, thus highlighting the importance of careful patient selection.
骨关节并发症在慢性肾衰竭患者中很常见，由于多因素病因导致的骨关节炎、股骨颈骨折或缺血性坏死，他们常常需要进行髋关节置换术（全髋或半髋）。1992年至2005年间，我们对18例接受肾脏替代治疗（10例血液透析和8例肾移植）的慢性肾衰竭患者（23髋）进行了手术，每例均植入了全髋或半髋假体。该组包括9名女性和9名男性，平均年龄56岁（范围：30 - 83岁）。5例为双侧病变。临床诊断为坏死（14例）、股骨颈骨折（5例）和骨关节炎（3例）。主要早期并发症为17例（74%）出血和6例（33%）感染（2例泌尿系统感染和4例手术伤口感染）。晚期并发症包括8例（35%）假体松动（5例无菌性和3例感染性）。手术相关死亡率为17%（3例）。接受肾脏替代治疗的患者进行人工髋关节手术具有较高的发病率和死亡率，因此凸显了谨慎选择患者的重要性。
