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Tri-Lock骨保留型股骨柄在中青年患者THA中的應(yīng)用

發(fā)布時(shí)間:2019-02-12 13:29
【摘要】:目的 探討Tri-Lock骨保留型股骨柄假體在中青年全髖關(guān)節(jié)置換術(shù)中應(yīng)用的短期臨床效果。方法自2011年03月至2013年08月,收集采用Tri-Lock骨保留型股骨柄假體進(jìn)行全髖關(guān)節(jié)置換術(shù)的病例19例(19髖)。取后外側(cè)股骨大粗隆后緣切口,50°截?cái)喙晒穷i,取出股骨頭,修整股骨頸,使用髓腔銼股骨遠(yuǎn)端擴(kuò)髓。擴(kuò)臼至能完全容納下臼杯,待徹底止血后置入人工臼杯。置入Tri-Lock標(biāo)準(zhǔn)頭頸,應(yīng)用C型臂X線機(jī)透視確定標(biāo)準(zhǔn)頭頸試模位置、松緊度、活動(dòng)度以及穩(wěn)定性,取出試模后,安裝陶瓷頸后復(fù)位。結(jié)果本組切口長(zhǎng)度(9.3±1.5)cm,術(shù)中出血量(300.0±141.0)ml。19例均獲得隨訪3~31(19.5±8.0)個(gè)月,術(shù)后無感染、下肢深靜脈血栓、關(guān)節(jié)脫位、異位骨化、假體松動(dòng)移位等并發(fā)癥發(fā)生。末次隨訪時(shí)疼痛均解除,雙下肢等長(zhǎng),無跛行,髖關(guān)節(jié)屈曲度70°~110°。術(shù)前髖關(guān)節(jié)功能Harris髖關(guān)節(jié)功能評(píng)分(58.4±18.6)分,末次隨訪時(shí)提高到(97.3±3.9)分,各分項(xiàng)及總分差異均有極顯著的統(tǒng)計(jì)學(xué)意義(P0.01)。術(shù)前雙側(cè)股骨偏心距差值為(4.9±2.9)mm,術(shù)后為(2.0±1.7)mm,差異有極顯著的統(tǒng)計(jì)學(xué)意義(t=3.76,P0.01)。結(jié)論Tri-Lock骨保留型股骨柄假體在中青年全髖關(guān)節(jié)置換術(shù)中應(yīng)用的短期臨床效果滿意。除了提高骨量保留,Tri-Lock骨保留型股骨柄假體還可以應(yīng)用于股骨遠(yuǎn)端病變或Dorr A型股骨的患者。
[Abstract]:Objective to investigate the short-term clinical effect of Tri-Lock bone-conserved prosthesis for total hip arthroplasty in young and middle-aged patients. Methods from March 2011 to August 2013, 19 patients (19 hips) underwent total hip arthroplasty with Tri-Lock bone reserved prosthesis. The femoral neck was cut off at 50 擄, the femoral head was removed, the femoral neck was repaired, and the distal end of the femur was reamed with a pulp cavity file. Extend the acetabulum to fully accommodate the bottom cup, after hemostasis, place the artificial cup. Tri-Lock standard head and neck were inserted, and the position, tightness, activity and stability of the standard head and neck were determined by using C arm X-ray machine. After the mould was removed, the ceramic neck was installed and reset. Results the incision length (9.3 鹵1.5) cm, intraoperative bleeding volume (300.0 鹵141.0) ml.19 patients were followed up for 30.31 (19.5 鹵8.0) months. There was no infection, deep vein thrombosis, dislocation of joint, ectopic ossification. Complications such as prosthetic loosening and displacement occurred. At the last follow-up, the pain was relieved, the lower limbs were equal in length, there was no claudication, and the flexion of hip joint was 70 擄~ 110 擄. The hip function score of Harris before operation was (58.4 鹵18.6), and it was increased to (97.3 鹵3.9) at the last follow-up. The difference of eccentricity of bilateral femur was (4.9 鹵2.9) mm, and (2.0 鹵1.7) mm, respectively (t = 3.76, P 0.01). Conclusion the short-term clinical effect of Tri-Lock bone-conserving prosthesis for total hip arthroplasty is satisfactory. In addition to improving bone retention, Tri-Lock bone reserved prosthesis can also be used in patients with distal femoral lesions or Dorr A femur.
【學(xué)位授予單位】:福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2015
【分類號(hào)】:R687.42

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