目的：评价普通非骨水泥股骨假体用于人工全髋关节翻修术的临床效果。方法对我科2008年1月-2011年11月期间行普通非骨水泥柄髋关节翻修手术的18例患者进行影像学和临床疗效评价。其中男性10例，女性8例；患者年龄45~76岁，平均58岁。行髋关节翻修的原因：假体周围感染10例，无菌性松动8例。所有患者翻修手术前后均行Harris评分和髋关节X线正侧位检查。结果18例均获得随访，随访时间6~42个月，平均30个月。术前Harris评分平均为39(23~53)分，截止最近一次随访评分均数增加至92(84~96)分。所有患者均在术后2~3个月完全负重，原有的疼痛也得到缓解。仅1例术后3个月门诊随访时诉大腿外侧有不适至轻度疼痛，口服双氯芬酸钠双释放胶囊75 mg 1/d，两周后症状消失。最近一次随访时，所有股骨假体均获得良好的骨长入。无明显并发症。仅1例术后两周脱位，给予手法复位单侧髋关节“人”字形石膏固定6周，随访6个月，未再脱位。结论普通非骨水泥股骨柄是部分髋关节翻修术中股骨假体翻修的良好选择，近期临床表现和X线检查结果令人满意。%Objective To assess the application of non-cement femoral stem prosthesis in total hip revision. Methods The clinical and radiographic outcomes in 18 patients (10 males and 8 females) aged 45-76 years (mean 58 years) after total hip revision with non-cement femoral prosthesis from January 2008 to November 2011 in our department were assessed. Ten patients underwent total hip revision due to infection of the prosthesis and 8 patients underwent total hip revision due to aseptic loosening of the prosthesis. The patients were scored according to the Harris scoring scale and their hip joint underwent anterioposterior and lateral X-ray examination before and after operation. Results The patients were followed up for 6-42 months (mean 30 months). The Harris score was 39 (23-53) before operation and was 92 (84-96) at the last follow-up. The patients could walk without crutch and their hip pain was alleviated 2-3 months after operation. Only one patient complained of uncomfortable feeling and mild pain in her lateral hip, which were dismissed after having 75 mg difene, once a day for two weeks. The femoral stem prosthesis grew into the hip at the last follow-up with no significant complication. Dislocation found in one patient 2 weeks after operation was fixed with cast for 6 weeks. The patient was followed up for 6 months, during which no dislocation occurred. Conclusion Non-cement femoral stem prosthesis is a good choice for total hip revision with satisfactory short-term clinical and radiographic outcomes.
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