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金属-松质骨非骨水泥吕贝克全髋关节置换术。5至9年的随访结果。

The Metal-Cancellous Cementless Lübeck total hip arthroplasty. Five-to-nine-year results.

作者信息

Matsui M, Nakata K, Masuhara K, Ohzono K, Sugano N, Ochi T

机构信息

Department of Orthopaedic Surgery, Osaka University Medical School, Suita, Japan.

出版信息

J Bone Joint Surg Br. 1998 May;80(3):404-10. doi: 10.1302/0301-620x.80b3.8108.

Abstract

We implanted 51 Metal-Cancellous Cementless Lübeck (MCCL) prostheses into 45 patients with dysplastic hips and followed 49 hips (96.1%) for five to nine years. One had needed revision for stem fracture and one for infection; the clinical outcome of the other 47 hips was assessed using the Merle d'Aubigné and Postel hip score. All hips were either excellent (63%) or good (37%). Three patients (6%) had mild thigh pain at six months, but this had settled within two years. Serial radiographs showed stable fixation with bone ingrowth in all hips, with increased density of the cancellous bone in contact with the implant and some trabecular ingrowth. There was early varus shift of the stem in one hip, but this stabilised in three months. Osteolysis of the femoral cortex was seen in one hip at seven years after surgery, and mild bone resorption due to stress shielding in 31 (63%). Acetabular bone grafting with autogenous bone from the femoral head gave successful support to the socket in 13 hips. The MCCL prosthesis gave satisfactory mid-term results in patients with osteoarthritis secondary to hip dysplasia.

摘要

我们为45例髋关节发育不良患者植入了51枚金属-松质骨非骨水泥吕贝克(MCCL)假体,并对49个髋关节(96.1%)进行了5至9年的随访。其中1例因股骨柄骨折需要翻修,1例因感染需要翻修;使用Merle d'Aubigné和Postel髋关节评分评估了其他47个髋关节的临床结果。所有髋关节的结果均为优(63%)或良(37%)。3例患者(6%)在6个月时出现轻度大腿疼痛,但在两年内症状消失。系列X线片显示所有髋关节固定稳定,有骨长入,与植入物接触的松质骨密度增加,并有一些小梁骨长入。1个髋关节的股骨柄早期出现内翻移位,但在3个月时稳定。术后7年,1个髋关节出现股骨干皮质骨溶解,31个髋关节(63%)因应力遮挡出现轻度骨吸收。采用股骨头自体骨进行髋臼植骨,成功支撑髋臼的有13个髋关节。MCCL假体在髋关节发育不良继发骨关节炎患者中取得了满意的中期结果。

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