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[40岁以下年轻患者的髋关节置换。临床统计经验报告]

[Replacement of the hip joint in young patients under 40 years of age. Clinico-statistical report of experiences].

作者信息

Mittelmeier H, Heisel J, Schmitt E

机构信息

Orthopädische Universitätsklinik Homburg/Saar.

出版信息

Z Orthop Ihre Grenzgeb. 1988 May-Jun;126(3):304-13. doi: 10.1055/s-2008-1040208.

Abstract

At Orthopedic Department of Homburg/Saar University Clinic there were - between 1974 and 1985 - altogether 270 cementless total hip replacements by AUTOPHOR-arthroplasty in 243 patients, who were 40 years of age and younger at time of operation. The male patients mostly suffered from posttraumatic joint destructions or idiopathic femoral head necrosis, the female patients from dysplasia coxarthritis. In 43.3% there were previous hip operations in the past. 6 septic failures (5 times removal of prosthesis); 33 (12.2%) aseptic failures, mostly of the femoral component with following exchange operation. Clinical and roentgenological control of 170 cases (septic and aseptic failures excluded). Subjectively good and very good results in 82.3%. Evaluation of clinical datas acc. to the scheme of Merle d'Aubigné. Improvement of preoperative situation (5.4 points average) to 14.7 points average postoperatively. In most of the patients, a professional and social integration could be achieved; only 28 patients received a pension. With regards to the functional inferior alternatives of resection hip rsp. hip arthrodesis, THR by cementless prostheses in young patients with severe joint destructions seems to be justifiable and recommendable - according to our medium-term results.

摘要

在洪堡/萨尔大学诊所骨科,1974年至1985年间,共对243例40岁及以下患者进行了270例采用AUTOPHOR关节成形术的非骨水泥全髋关节置换术。男性患者大多患有创伤后关节破坏或特发性股骨头坏死,女性患者则患有髋关节发育不良性关节炎。43.3%的患者过去曾接受过髋关节手术。6例感染性失败(5次假体取出);33例(12.2%)无菌性失败,主要是股骨部件,随后进行了翻修手术。对170例病例进行了临床和影像学检查(排除感染性和无菌性失败病例)。主观上良好和非常好的结果占82.3%。根据Merle d'Aubigné方案评估临床数据。术前情况平均改善(5.4分)至术后平均14.7分。大多数患者能够实现职业和社会融合;只有28例患者领取养老金。就切除髋关节或髋关节融合术等功能较差的替代方法而言,根据我们的中期结果,对于患有严重关节破坏的年轻患者,采用非骨水泥假体进行全髋关节置换似乎是合理且值得推荐的。

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