Objective To evaluate the early clinical effect of preserving femoral neck in total hip arthroplasty. Methods Twelve panents( 14 hips)were underwent total hip arthroplasty with preservation of the femoral neck. We cut off the femoral head in infra-head position with improved Moore micro-incisions to reserve intact neck of femur. The suitable size of extra cup was selected and placed at 55° eversion angle. The internal cup which was made from ultra high molecular weight polyethylene and with ultra radius design, was placed at 45° eversion angle. Clinical evaluation was done based on Harris hip score during the follow-up and the X-ray films were taken to assess position, loosening of the prosthesis and ectopic ossification. Results The bilateral distal femur prosthesis of a bilateral patient cracked owing to excessive amputation of the collum femoris and the fractures healed after symptomatic treatment. All 12 patients were followed up 15-27 months with an average of 18. 4 months. The mean Harris hip score elevated from 52 before operation to 91 of the last follow-up(P＜0. 05), The X-ray showed that the positions of artificial hip joint were good, without loosening or sinking of prosthesis. Conclusion Total hip arthroplasty with collum femoris preseving can retan more bone, be easier for revision and has an excellent outcome.%目的 评估保留股骨颈型全髋关节置换术早期临床疗效.方法 对12例(14髋)因各种因为行保留股骨颈型人工髋关节置换术患者均采用改良Moore小切口,在头下位置将股骨头截断,保留完整的股骨颈;选择合适的外杯.外翻55°装入,内杯为超高分子聚乙烯,超半径设计保持外翻45°.随访时采用Harris髋关节评分标准进行临床评价,摄X线片了解假体位置、松动情况及异位骨化.结果 1例双髋患者术中截除股骨颈过多,致双侧假体柄远端股骨劈裂骨折,夹板固定后骨折愈合.12例均获随访15～27个月,平均18.4个月.Harris评分由术前平均52分,提高到末次随访时平均91分.差异有统计学意义(P<0.05).X线片显示髋关节化置良好,假体无松动和下沉.结论 保留股骨颈型全髋关节置换术治疗中青年髋关节疾病,保留了更多宿主骨质,利于再次假体翻修,临床疗效良好.
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