【摘要】：目的探討應(yīng)用大號生物型臼杯(Jumbo臼杯)行髖關(guān)節(jié)翻修術(shù)后髖關(guān)節(jié)旋轉(zhuǎn)中心(hip center of rotation,COR)和股骨偏心距的變化。方法回顧性分析2010年1月—2015年5月應(yīng)用Jumbo臼杯行髖關(guān)節(jié)翻修術(shù)的23例患者臨床資料,其中8例聯(lián)合顆粒骨植骨,10例聯(lián)合顆粒骨植骨并結(jié)構(gòu)性植骨。男10例,女13例;年齡51~77歲,平均65.4歲。初次人工全髖關(guān)節(jié)置換術(shù)至翻修術(shù)間隔1~24年,平均8.57年。髖關(guān)節(jié)翻修原因:無菌性松動21例,假體周圍感染2例�；颊逪arris評分為(43.04±5.05)分,疼痛視覺模擬評分(VAS)為(5.70±0.97)分。骨缺損根據(jù)Paprosky分型標準,Ⅰ型5例,ⅡA型5例,ⅡB型3例,ⅡC型6例,ⅢA型4例。雙髖X線片測量示,健側(cè)股骨偏心距為(40.65±4.09)mm,患側(cè)為(44.04±5.08)mm,比較差異有統(tǒng)計學(xué)意義(t=4.098,P=0.000);10例(43.48%)股骨偏心距重建,13例(56.52%)未重建;10例(43.48%)COR重建,11例(47.83%)COR上移,2例(8.69%)COR下移。結(jié)果術(shù)后切口均Ⅰ期愈合,無感染、血管損傷、下肢深靜脈血栓形成、關(guān)節(jié)脫位、假體周圍骨折等并發(fā)癥發(fā)生�；颊呔@隨訪,隨訪時間12~76個月,平均22.48個月。術(shù)后1年Harris評分為(82.09±4.53)分,VAS評分為(0.74±0.62)分,與術(shù)前比較差異均有統(tǒng)計學(xué)意義(t=37.831,P=0.000;t=22.318,P=0.000)。X線片復(fù)查示,翻修術(shù)后1年患側(cè)股骨偏心距為(43.87±3.57)mm,與術(shù)前比較差異無統(tǒng)計學(xué)意義(t=0.250,P=0.805),與健側(cè)比較差異有統(tǒng)計學(xué)意義(t=5.591,P=0.000)。翻修術(shù)后患側(cè)股骨偏心距重建16例(69.57%),未重建7例(30.43%);15例(65.22%)COR重建,8例(34.78%)COR上移。結(jié)論單純應(yīng)用Jumbo臼杯行髖關(guān)節(jié)翻修術(shù)可能導(dǎo)致COR上移和股骨偏心距增加。合理安放Jumbo臼杯以及正確處理髖臼骨缺損,能夠最大限度恢復(fù)COR和股骨偏心距,獲得良好近期療效,假體穩(wěn)定性可。
[Abstract]:Objective to investigate the changes of hip rotation center (hip center of rotation,COR) and femoral eccentricity after hip revision with large biological acetabular cup (Jumbo cup). Methods from January 2010 to May 2015, the clinical data of 23 patients undergoing revision of hip joint with Jumbo cup were retrospectively analyzed. Among them, 8 cases were combined with granular bone graft, 10 cases were combined with granular bone graft and structural bone graft. There were 10 males and 13 females, aged 51 to 77 years, with an average age of 65.4 years. The interval between primary total hip replacement and revision was 1 ~ 24 years (mean 8.57 years). The causes of hip revision were aseptic loosening in 21 cases and periprosthetic infection in 2 cases. The Harris score was (43.04 鹵5.05) and the pain visual analogue score (VAS) was (5.70 鹵0.97). According to Paprosky classification criteria, there were 5 cases of type 鈪，

本文編號：2417649