金属对金属与金属对聚乙烯全髋假体疗效比较

摘要

Objective To compare the early follow-up clinical result of the large diameter metal-on-metal (MOM) with traditional metal-on-polyethylene(MOP) total hip arthroplasty(THA). Methods From July 2007 to July 2010, there were 64 cases (32 cases each) were studied. 32 cases were treated with lrage diameter MOM prothesis,which in-clued 17 males and 15 females,with the mean age of 52. 3. And 32 cases were treated with traditional 28 mm diameter THA prothesis,which indued 16 males and 16 females,with the mean age of 53. 4, There are no statistics difference in gender,age,weight,preoperative diagnosis,joint movement and harris scores of the two groups. Compare the incision length,operation time,bleeding,postoperative Hemoglobin decrease,fumer perimeter,in-patient time,complications, joint move sphere dislocation of two groups. Results All cases were followed up 6～36 months,with the mean time of 22. 9 months. There no statistics difference in incision longness,operation time,bleeding,postoperative Hemoglobin decrement, complications of the two groups (P>0. 05), But the hip joint movement .stability and dislocation of the LMM-THA were better than traditional MP-THA. Conclusion Compare with traditional MP-THA, LMM-THA have better hip joint movement,stability,not increased operation trauma and complication.%目的 比较大直径金属对金属全髋关节假体(large diameter metal-on-metal cementless total arthroplasty,LMM-THA)与传统直径(28 mm金属对高分子聚乙烯)全髋关节假体金属对聚乙烯(metal-on-polyethylene cementless total hip arthroplasty,MP-THA)置换术早期临床疗效.方法 回顾性分析2007年7月至2010年7月应用LMM-THA与传统28 mm直径MP-THA置换术各32例(32髋)患者的临床资料.LMM-THA组男性17例,女性15例,年龄38～69岁,平均52.3岁.传统直径MP-THA组男性16例,女性16例；年龄40～71岁,平均53.4岁.两组患者性别、年龄、体重、术前诊断、关节活动范围、Harris评分无统计学差异,比较两者的切口长度、手术时间、出血量、手术前后血红蛋白(Hemoglobin,Hb)减少量、大腿周径增加值、住院时间、术后并发症及假体的位置,假体活动范围,假体脱位发生率.结果 两组患者随访6～36个月,平均22.9个月.两组间切口长度、手术时间、出血量、手术前后Hb减少量、大腿周径增加值、住院时间、Harris评分经统计学处理均无显著性差异(P＞0.05),而髋关节活动范围及髋关节稳定性脱位发生率LMM-THA组优于传统MP-THA组.结论 LMM-THA假体比MP-THA组不增加手术创伤及并发症,但有着更好的关节活动范围及关节稳定性.