年轻人无骨水泥全髋关节置换术的中期结果

A. Kawalkar, Chandrashekher Martand Badole, Ajit Phadke
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引用次数: 2

摘要

导言:有多种病因可能导致青年成人髋关节关节炎。因此,骨科医生经常会遇到非常年轻的终末期髋关节关节炎患者,需要进行手术干预。在过去,髋关节置换术或关节切除术被用于治疗年轻患者的终末期髋关节关节炎,但最近全髋关节置换术成为上述手术的可行替代方案。高活动水平、重复负荷和对髋关节的过度要求,以及植入材料的耐久性问题,导致过去年轻患者全髋关节置换术的失败率很高。这项前瞻性研究的目的是评估这些现代无骨水泥THA在年龄小于40岁的终末期关节炎患者中的临床和影像学结果。材料和方法:一项前瞻性研究,25例(28髋)年龄小于40岁的髋关节关节炎患者接受了原发性无骨水泥全髋关节置换术。Taperloc股骨假体采用多孔涂层无水泥髋臼杯和高度交联聚乙烯衬垫。Harris髋关节评分用于确定功能预后,活动水平通过Johnston等人的分类进行评估。放射学分析包括髋关节和骨盆的前后视图,髋关节的真正侧面视图。观察与结果:所有25例患者均可进行临床和影像学评估。优良率为93%;没有一例髋部临床结果不佳。x线检查显示骨长入的一致证据。没有股骨假体松动或需要翻修。结论:对于40岁以下的年轻患者,无骨水泥全髋关节置换术可以安全、成功地进行,短中期随访效果良好。
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Midterm results of cementless total hip arthroplasty in young
Introduction: There are a variety of etiological factors that may result in arthritis of the hip in young adults. There are, therefore, not infrequent occasions when orthopedic surgeons may encounter very young patients with end-stage arthritis of the hip necessitating surgical intervention. In the past hip arthrodesis or resection arthroplasty were used to address end-stage arthritis of the hip in young patients but recently total hip arthroplasty emerged as the viable alternative to above surgical procedures. The high activity level, repetitive loading and excessive demand placed on the hip on one hand and issues of durability of the implant materials on the other lead to high failure rates of total hip arthroplasty in young patients in the past. The aim of this prospective study was to evaluate the clinical and radiographic results of these modern cementless THA in patients with end stage arthritis who were younger than 40 years of age. Materials and Methods: A prospective study was carried out in which 25 patients (28 hips) younger than 40 years with hip arthritis underwent primary cementless total hip arthroplasties participated. The Taperloc femoral component with Porous coated cementless acetabular cup and highly crossed linked polyethylene liner was used in all hips. The Harris hip score was used to determine functional outcome and activity level was evaluated by the classification of Johnston et al. Radiographic analysis consisted of antero-posterior views of the hip and pelvis, a true lateral view of the hip. Observations and Results: All 25 patients were available for both clinical and radiographic evaluation. 93% of patients had excellent to good; and none of the hips had poor clinical outcome. Radiographic assessment revealed consistent evidence of bony ingrowth. No femoral component was loose or required revision. Conclusion: Cementless total hip arthroplasty can be safely and successfully performed in young patients less than 40 years with excellent results in short to midterm follow-up.
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