Zhang Xia, Hao Yong
Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Oct;24(10):1185-8.
To investigate the methodology and efficacy evaluation of ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients.
The clinical data from 65 patients (75 hips) who received ceramic on ceramic hip prosthesis for total hip arthroplasty between February 2004 and September 2006, including unilateral replacement in 55 cases and bilateral replacement in 10 cases. Of 65 patients, there were 41 males and 24 females with an average age of 43.2 years (range, 18-56 years), including 6 cases of femoral head comminuted fractures, 44 cases of aseptic necrosis femoral head, 7 cases of developmental dysplasia of hip with osteoarthritis, 3 cases of congenital dislocation of hip, 2 cases of traumatic arthritis secondary to postoperative acetabulum fracture, 1 case of rheumatoid arthritis, and 2 cases of ankylosing spondylitis. The Harris score was 54.3 +/- 6.7. The disease duration was 1 year and 4 months to 10 years and 7 months with an average of 3 years and 2 months.
Healing of incision by first intention was achieved in all patients; no dislocation, infection, and deep venous thrombosis of lower limbs occurred. All patients were followed up 3 years and 2 months to 5 years and 7 months with an average of 4 years and 9 months. The Harris score was significantly improved to 89.0 +/- 9.4 at last follow-up, showing significant difference when compared with preoperative one (P < 0.01). The mean eversion angle and anteversion angle of the acetabular component were (43.6 +/- 8.4) degrees and (21.5 +/- 3.5) degrees, respectively. In follow-up period, no prosthetic loosening, subsidence, dislocation, and ceramic component fracture occurred. Osteolysis was not found in all the cases.
Ceramic on ceramic hip prosthesis in total hip arthroplasty for young patients can effectively decrease the complications of prosthetic loosening and subsidence caused by wearing of joint interface; the surgical skill is important in decreasing dislocation and fraction of ceramic on ceramic hip prosthesis.
探讨在年轻患者全髋关节置换术中应用陶瓷对陶瓷髋关节假体的方法及疗效评估。
选取2004年2月至2006年9月期间行陶瓷对陶瓷髋关节假体全髋关节置换术的65例患者（75髋）的临床资料，其中单侧置换55例，双侧置换10例。65例患者中，男性41例，女性24例，平均年龄43.2岁（18 - 56岁），包括股骨头粉碎性骨折6例、股骨头无菌性坏死44例、髋关节发育不良伴骨关节炎7例、先天性髋关节脱位3例、髋臼骨折术后创伤性关节炎2例、类风湿关节炎1例、强直性脊柱炎2例。Harris评分54.3±6.7。病程1年4个月至10年7个月，平均3年2个月。
所有患者切口均一期愈合；未发生脱位、感染及下肢深静脉血栓形成。所有患者随访3年2个月至5年7个月，平均4年9个月。末次随访时Harris评分显著提高至89.0±9.4，与术前比较差异有统计学意义（P < 0.01）。髋臼假体的平均外翻角和前倾角分别为（43.6±8.4）°和（21.5±3.5）°。随访期间未发生假体松动、下沉、脱位及陶瓷部件骨折。所有病例均未发现骨溶解。
在年轻患者全髋关节置换术中应用陶瓷对陶瓷髋关节假体可有效减少因关节界面磨损导致的假体松动和下沉并发症；手术技巧对于减少陶瓷对陶瓷髋关节假体的脱位和断裂很重要。
