非骨水泥型髋假体进行髋关节翻修的四年随访研究

目的　评价非骨水泥型髋关节系统治疗人工全髋关节翻修术的术后中期临床随访效果。方法　自1996年11月至2001年1月,对55例56髋关节行翻修术,采用了Zweymüller非骨水泥人工髋关节系统,年龄30~80岁,平均59岁。均有至少两年以上的临床和放射学追踪资料,平均随访时间4年。结果　32例32髋得到随访, 23例24髋失访。有3例出现围手术期并发症: 1例为假体取出时大转子骨折, 1例为术后2d脱位并成功闭合复位, 1例为伤口深部感染需要再次清创。无髋臼及股骨柄假体需要再度翻修。Harris评分由术前平均40 6分提高到最末次随访平均80 4分。X线片示髋臼和股骨柄假体位置满意,无松动和感染征象,周围骨质内向长入。结论　中期临床结果显示,初次用骨水泥和非骨水泥固定人工髋关节置换失败的病例,若髋臼环完整,使用非骨水泥型髋关节假体可以获得良好的临床效果。

Revision hip arthroplasty with the cementless prosthesis: 4 years follow-up study

OBJECTIVE: To examine the two to eight-year results associated with the use of this hip system. METHODS: Between November 1996 and January 2001, 56 revision total hip arthroplasties with insertion of a Zweymüller BICON-PLUS cup and a cementless SLR-PLUS stem were performed in 55 consecutive patients (average age, fifty-nine years old, range, thirty to eighty years old). RESULTS: At the time of the latest follow-up, 23 patients (24 hips) had lost to follow-up, leaving 32 patients for a minimum of 2 years of clinical and radiographical follow-up. The mean follow-up time was 4 years. Only 3 peri-operative complications occurred, including 1 great trochanter fracture during implant removal, 1 dislocation 2 d after operation with successful closed reduction, and 1 deep wound infection which necessitated reentry and debridement. No femoral stems or cups needed re-revision surgery. The average Harris hip score increased from 40.6 points preoperatively to 80.4 points at final follow-up. Radiographic analysis demonstrated that the position of stems and cups was unchanged and all showed radiographic evidence of bone ingrowth. CONCLUSION: The favourable medium-term clinical results with the cementless Zweymüller hip system show that it is suitable as a revision system for total hip failures of both cemented and cementless primary fixation.