大头径Delta陶瓷人工髋关节临床应用的早期结果

摘要

Objective To investigate the early clinical and radiographic evaluation of large femoral head Delta ceramic-onceramic articulation in primary THA.Methods We retrospective analyzed Delta ceramic-on-ceramic primary total hip replacements with 36mm diameter of large femoral head in a series of 25 cases.We assessed patients clinically,radiographically,and reported perioperative complications.Results Healing of incision by first intention was achieved in all patients; no dislocation and infection.One patient underwent liner ceramic fractured in intraoperative.All the patients were followed up from 12 months to 36 months.Postoperative total Harris score of the two groups was more significant improved as compared with preoperative (P＜0.05).No patient reported squeaking related to the orthopaedic device.No aseptic loosening,ceramic liner and head fracture or osteolysis was observed.Conclusion The results of total hip arthroplasty with a 36mm diameter of large femoral head,Delta ceramic-on-ceramic bearing were encouraging.The improved material properties of this ceramic combined with the ability to use larger-diameter heads and liners to reduce instability and wear.%目的 探讨临床应用大直径球头(36mm) Delta陶瓷-陶瓷界面人工髋关节的早期结果.方法 回顾分析2009年10月至2011年10月25例(25髋)采用36mm大直径球头Delta陶瓷-陶瓷界面全髋假体行初次人工全髋关节置换(THA)治疗髋关节疾病患者的病例资料,根据术后随访Harris评分系统和影像学资料进行髋关节功能和假体情况评估,并报告术中及术后并发症.结果 关节置换后切口均Ⅰ期愈合,未发生假体脱位、感染.l例患者出现术中陶瓷内衬破裂.25例均获随访,时间12～36月,平均2年3个月.术前Harris评分为(52.5±5.4)分,末次随访时,Harris评分为(91.0±7.4)分,与术前比较差异有统计学意义(P＜0.05).没有患者报告与关节相关的异响.随访期间影像学检查未见假体松动、下沉、移位及碎裂发生,骨溶解.结论 大直径球头Delta陶瓷人工髋关节临床应用的早期结果满意,其陶瓷材料性能的改善和使用大头径假体可以减少关节假体磨损和脱位的发生率.