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骨水泥型聚乙烯内衬技术在髋关节翻修术中应用的回顾性研究

[A retrospective study on the application of cemented polyethylene liner technique in hip revision].

作者信息

Li Zhichen, Lu Weijie, Zhao Jie, Chen Yi, Chen Dongfeng, Zheng Chong

机构信息

Department of Orthopedics, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120, P.R.China.

Department of Orthopedics, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong, 510120,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Sep 15;32(9):1157-1161. doi: 10.7507/1002-1892.201803071.

Abstract

OBJECTIVE

To evaluate the effectiveness of cemented polyethylene liner technique in hip revision.

METHODS

Based on inclusion criteria, the clinical data of 26 patients who were undergone hip revision between January 2011 and December 2013, were retrospectively reviewed. Among them, 14 cases were treated with isolated liner exchange (group A) and 12 cases were treated with cemented polyethylene liner technique (group B). There was no significant difference in gender, age, the time from primary total hip arthroplasty to revision, and the preoperative Harris score between 2 groups ( >0.05). The post-operative Harris score and complications were compared between 2 groups, and X-ray findings of the hip joint were recorded to review the position of hip components.

RESULTS

All patients were followed up 4.4-6.4 years (mean, 5.4 years). Except for two femoral fractures during the revision (1 in each group), there was no other complication in 2 groups. The hip pain relieved and the lame gait corrected in 2 groups. The hip's function of 2 groups improved gradually after operation, with a better Harris score at 3 months and the best at the last follow-up, compared with preoperative scores ( <0.05). There was no significant difference in Harris score at difference time points after operation between 2 group ( >0.05). X-ray films showed no dislocation, aseptic loosening, and other interface related complication.

CONCLUSION

For the cases without the chance to do change liner, cemented polyethylene liner technique has a good effectiveness. But restrict patient selection should be considered before hip revision.

摘要

目的

评估骨水泥固定聚乙烯内衬技术在髋关节翻修术中的有效性。

方法

根据纳入标准,回顾性分析2011年1月至2013年12月期间接受髋关节翻修术的26例患者的临床资料。其中,14例采用单纯内衬置换治疗(A组),12例采用骨水泥固定聚乙烯内衬技术治疗(B组)。两组患者在性别、年龄、初次全髋关节置换至翻修的时间以及术前Harris评分方面差异均无统计学意义(>0.05)。比较两组患者术后的Harris评分及并发症情况,并记录髋关节X线表现以评估髋关节假体位置。

结果

所有患者均获随访4.4 - 6.4年(平均5.4年)。除翻修术中两组各发生1例股骨骨折外,两组均无其他并发症。两组患者髋关节疼痛均缓解,跛行步态均纠正。两组患者术后髋关节功能均逐渐改善,术后3个月Harris评分优于术前,末次随访时最佳,差异均有统计学意义(<0.05)。两组术后各时间点Harris评分差异均无统计学意义(>0.05)。X线片显示无脱位、无菌性松动及其他界面相关并发症。

结论

对于无内衬更换机会的病例,骨水泥固定聚乙烯内衬技术效果良好。但在髋关节翻修术前应谨慎选择患者。

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