三代氧化铝陶瓷对陶瓷全髋关节置换的早期疗效观察

摘要

Objective To evaluate short-term clinical results of third-generation ceramic-on-ceramic( COC ) total hip arthroplasty. Methods 82 total hip arthroplasties on 69 patients were performed using COC bearings at our institution. Control group ( 33 hips in 29 cases ) were treated by total hip arthroplasty with metal-on-highly cross-linked polyethylene ( MOP ) bearings in the same period. All patients were evaluated clinically and radiographically respectively, and the results were collected to compare the outcomes and complications. Clinical evaluation was performed using HHS. Results 98 patients were followed up for 13 ~42( 23. 7 ±6. 7 )months. The HHS and radiographic outcomes were similar in both groups. Postoperative HHS of the two groups was more significantly improved as compared with those of the two groups preoperative. There were three dislocations ( 3. 7% ) in the trial group and two( 6. 1% ) in the control group;Two patients ( 2.4% )reported squeaking and a transient nerve injury occurred in one patient in the COC group. No ceramic fractures occurred in COC group; Two patients occurred leg length discrepancy in the COC and MOP group respectively. After analysis of the radiographic images, all femoral implants and acetabular component were well fixed in the two groups. Conclusions Total hip arthroplasty with a third-generation COC bearing had good stability, and there is no significantly difference when comparing with MOP bearings in the short term. The short-term clinical effect show promising results.%目的 分析三代氧化铝陶瓷对陶瓷(COC)全髋关节置换的早期临床疗效.方法 采用COC全髋关节置换治疗69例髋关节疾病患者(82髋);选取同期采用金属对高交联聚乙烯(MOP)治疗的29例患者(33髋),对比两组HHS评分和影像学资料,分析并发症情况.结果 本组均获随访,时间13～42(23.7±6.7)个月.两组术后Harris评分较术前均有明显改善(P<0.05),两组患者髋臼及股骨柄假体位置良好.两组患者Harris评分及影像学结果相近,COC组发生脱位3例(3.7%),异响2例(2.4%),一过性坐骨神经牵拉1例(1.2%),双下肢不等长2例(2.9%),术中及术后随访中未见陶瓷组件碎裂;MOP组发生脱位2例(6.1%),双下肢不等长2例(6.9%).结论 三代COC全髋关节置换术关节稳定性良好,短期内临床应用结果与MOP相似,早期临床效果满意.