全髋关节置换术中高交联聚乙烯髋臼杯内衬与传统聚乙烯髋臼杯内衬的对比研究

[Comparative study on high cross-linked and traditional polyethylene cup liners in total hip arthroplasty].

作者信息

Wei Zhaoquan, Sun Junying, Zha Guochun, Dong Shengjie, Wang Tao, Fany Yuan

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Dec;27(12):1414-8.

Abstract

OBJECTIVE

To compare the effectiveness and linear wear rates between high cross-linked polyethylene cup liner and traditional polyethylene cup liner.

METHODS

A retrospective analysis was made on the clinical data of 61 patients (64 hips) who underwent primary total hip arthroplasty (THA) between January 2005 and March 2007. According to the type of cup liner, 61 patients (64 hips) were divided into 2 groups: high cross-linked polyethylene cup liner was used in 30 cases (31 hips, trial group), and traditional polyethylene cup liner in 31 cases (33 hips, control group). There was no significant difference in gender, age, body weight, etiological factor, and preoperative Harris score between 2 groups (P > 0.05). Complication was observed after operation; Harris score was used to assess hip function; X-ray film analysis was done to observe osteolysis and prosthesis loosening, and to measure cumulative penetration of the femoral head and linear wear rate.

RESULTS

All incisions healed by first intention without complication. All patients were followed up. The mean follow-up was 6.3 years (range, 5-7 years) in trial group, and was 6.5 years (range, 4-7 years) in control group. There was no significant difference in Harris score between 2 groups at the 3 months after operation and last follow-up (P > 0.05). Osteolysis was observed in 3 cases (3 hips) of control group, but no osteolysis in trial group. X-ray films showed no aseptic loosening in the patients of 2 groups. The mean cumulative penetration of trial group were significantly lower than those of control group at 1-7 years after operation (P < 0.05). Linear wear rate of trial group [(0.025 +/- 0.002) mm/year] was significantly lower than that of control group [(0.086 +/- 0.005 ) mm/year] (Z=6.804, P=0.000).

CONCLUSION

High cross-linked polyethylene cup liner has the similar effectiveness as traditional polyethylene cup liner, but it has lower linear wear rate than the traditional polyethylene cup liner.

摘要

目的

比较高交联聚乙烯髋臼杯衬垫与传统聚乙烯髋臼杯衬垫的有效性及线性磨损率。

方法

对2005年1月至2007年3月期间接受初次全髋关节置换术（THA）的61例患者（64髋）的临床资料进行回顾性分析。根据髋臼杯衬垫类型，将61例患者（64髋）分为2组：试验组30例（31髋）采用高交联聚乙烯髋臼杯衬垫，对照组31例（33髋）采用传统聚乙烯髋臼杯衬垫。两组患者在性别、年龄、体重、病因及术前Harris评分方面差异均无统计学意义（P>0.05）。术后观察并发症情况；采用Harris评分评估髋关节功能；通过X线片分析观察骨溶解及假体松动情况，并测量股骨头的累积下沉量及线性磨损率。

结果

所有切口均一期愈合，无并发症发生。所有患者均获随访。试验组平均随访6.3年（范围5 - 7年），对照组平均随访6.5年（范围4 - 7年）。术后3个月及末次随访时两组Harris评分差异均无统计学意义（P>0.05）。对照组有3例（3髋）出现骨溶解，试验组未出现骨溶解。X线片显示两组患者均无无菌性松动。试验组术后1 - 7年的平均累积下沉量显著低于对照组（P<0.05）。试验组的线性磨损率为（0.025±0.002）mm/年，显著低于对照组的（0.086±0.005）mm/年（Z = 6.804，P = 0.000）。