Hu Yihe, Wang Long, Liu Hua, Li Kanghua, Liao Qiande
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha Hunan 410008, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2010 Oct;24(10):1189-91.
To discuss the therapeutic effect of distal fixed modular femoral prosthesis for the hip prosthesis revision.
Between August 2004 and May 2008, cementless modular femoral prosthesis was used for hip prosthesis revision in 21 cases. There were 9 males and 12 females, aged from 49 to 72 years (mean, 64.6 years). The time from revision to total hip arthroplasty was 2 to 18 years (mean, 11.7 years). The causes of revision included aseptic loosening in 19 cases (5 cases were periprosthetic femoral fracture), and deep infection in 2 cases. First revision was given in all patients. Preoperative Harris score was 41.8 +/- 3.5; pain visual analogue score (VAS) was 7.62 +/- 0.86.
All patients achieved healing of incision by first intention, and no deep venous thrombosis and nerve injury occurred. Twenty-one cases were followed up 2 to 6 years with an average of 4.3 years. No prosthetic loosening or infection occurred. Bone ingrowth was observed around the implant during the follow-up period. At last follow-up, 2 cases had femoral stem subsidence without obvious hip pain and other symptoms, and no special treatment was given. Harris score was 82.7 +/- 3.3 and VAS score was 0.19 +/- 0.51 at last follow-up, showing significant differences when compared with those before operation (P < 0.05).
The short-term result of modular femoral prosthesis is satisfactory in hip prosthesis revision, and it can improve the hip function and relieve the pain greatly.
探讨股骨远端固定组合式假体在髋关节翻修术中的治疗效果。
2004年8月至2008年5月，采用非骨水泥型组合式股骨假体对21例患者进行髋关节翻修术。其中男性9例，女性12例，年龄49～72岁（平均64.6岁）。翻修距初次全髋关节置换的时间为2～18年（平均11.7年）。翻修原因包括无菌性松动19例（其中5例为假体周围股骨骨折），深部感染2例。所有患者均为首次翻修。术前Harris评分为41.8±3.5；疼痛视觉模拟评分（VAS）为7.62±0.86。
所有患者切口均一期愈合，未发生深静脉血栓形成及神经损伤。21例患者随访2～6年，平均4.3年。无假体松动或感染发生。随访期间可见植入物周围有骨长入。末次随访时，2例患者出现股骨柄下沉，但无明显髋关节疼痛及其他症状，未给予特殊处理。末次随访时Harris评分为82.7±3.3，VAS评分为0.19±0.51，与术前比较差异有统计学意义（P<0.05）。
组合式股骨假体用于髋关节翻修术的短期效果满意，能显著改善髋关节功能，缓解疼痛。
