仿生双动全髋关节置换重建髋关节的早期疗效研究
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国家自然科学基金资助项目(81702205);江苏省自然科学基金资助项目(BK20170141)


The early curative effect of dual mobility cup total hip arthroplasty for the hip reconstruction
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    摘要:

    目的:评价仿生双动全髋关节置换重建髋关节的可行性、安全性、初始稳定性及早期临床疗效。方法:2019年1—6月利用仿生双动全髋关节置换完成25例髋关节重建,其中,男9例,女16例;年龄(70.20±6.94)岁,所有患者均为新鲜股骨颈骨折。记录手术完成时间、术中出血量、术后引流量。术后门诊随访,复查髋关节X线片,分别采用视觉模拟度量表(visual analogue scale,VAS)、Harris功能评分(Harris hip score,HHS)以及Mayo髋关节功能评分(Mayo hip score,MHS)评估患髋局部疼痛改善和髋关节功能恢复情况。结果:所有患者均完成有效随访,随访时间(13.55±0.99)个月(12~15个月);手术时间为(1.36±0.25)h,术中出血量为(275.00±77.17)mL,术后引流量为(236.11±76.32)mL;术后门诊复查髋关节X线显示:关节假体位置良好、关节力线恢复满意,关节假体和骨接触面紧密接触、无缝隙。术前VAS评分(5.61±0.97)分降至术后12个月(0.11±0.12)分(t=26.92,P<0.001);HHS评分由术前(3.77±1.40)分升至术后12个月(91.83±4.88)分(t=-86.73,P<0.001);MHS功能评分术后12个月(89.10±5.22)分;所有患者均未发生血管神经损伤、感染、假体脱位、血管栓塞等手术相关并发症。结论:仿生双动全髋关节置换能够有效重建髋关节,增加髋关节稳定性,恢复髋关节功能,早期临床效果满意。

    Abstract:

    Objective:This study aims to explore the feasibility,safety,initial stability and early clinical efficacy of dual mobility cup total hip arthroplasty for the hip reconstruction. Methods:Total 25 patients with the fresh femoral neck fracture (9 male and 16 female),with age of (70.20±6.94) years old,were treated with dual mobility cup THA from January 2019 to June 2019. The operative duration,intraoperative blood loss,postoperative blood loss complications were recorded. All patients were followed up postoperatively. Visual analogue scule(VAS),Harris hip score(HHS) and Mayo hip score(MHS) were recorded to evaluate the improvement of hip local pain and recovery of hip function. Results:Patients were postoperative follow-up in time with an average of (13.55±0.99) months. The mean operative duration was (1.36±0.25) h;the mean blood loss was (275.00±77.17) mL and the mean postoperative blood loss was (236.11±76.32) mL;The X-ray of the postoperative hip joint showed that the joint prosthesis was in good position,the force line of the joint recovered satisfactorily,and the joint prosthesis was in close contact with the bone contact surface without any gaps. The mean VAS scores ranged from (5.61±0.97) points preoperatively to (0.11±0.12) points(t=26.92,P<0.001)at 12 months postoperatively. The average HHS ranged from (3.77±1.40) points preoperatively to (91.83±4.88) points(t=-86.73,P<0.001)at 12 months postoperatively. The average MHS was (89.10±5.22) points at 12 months postoperatively. None of the patients had any complications related to surgery,such as vascular nerve injury,infection,dislocation of prosthesis,vascular embolization. Conclusion:The preliminary clinical result of dual mobility cup total hip arthroplasty is satisfactory for the hip reconstruction,increasing the stability of the hip joint,and restoring the function of the postoperative hip joint.

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李旭祥,凌 辰,张惠康,姚庆强,徐 燕,唐 成,王黎明.仿生双动全髋关节置换重建髋关节的早期疗效研究[J].南京医科大学学报(自然科学版),2021,(2):212-215

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  • 收稿日期:2020-10-13
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  • 在线发布日期: 2021-03-10
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