[1]赵德伟,马志杰,杨磊,等.多孔钽金属涂层髋关节假体置换治疗老年股骨颈骨折的临床疗效观察[J].中华老年骨科与康复电子杂志,2016,(02):92-96.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
 Zhao Dewei,Ma Zhijie,Yang Lei,et al.Clinical investigation of hip implants by using porous tantalum coating in the treatment of elderly femoral neck fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(02):92-96.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
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多孔钽金属涂层髋关节假体置换治疗老年股骨颈骨折的临床疗效观察()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2016年02期
页码:
92-96
栏目:
髋部骨折
出版日期:
2016-05-17

文章信息/Info

Title:
Clinical investigation of hip implants by using porous tantalum coating in the treatment of elderly femoral neck fractures
作者:
赵德伟马志杰杨磊王本杰谢辉黄诗博王子华田思淼
116001 大连大学附属中山医院骨一科
Author(s):
Zhao Dewei Ma Zhijie Yang Lei Wang Benjie Xie Hui Huang Shibo Wang Zihua Tian Simiao.
Orthopaedic Department, ZhongShan Hospital of Dalian University, Dalian 116001, China
关键词:
关节成形术置换 老年人 骨质疏松症 股骨颈骨折 多孔钽涂层
Keywords:
Arthroplasty replacement hip Aged Osteoporosis Femoral neck fractures  Porous tantalum coating
DOI:
10.3877/cma.j.issn.2096-0263.2016.02.006
摘要:
目的 探讨多孔钽金属涂层髋关节假体治疗老年股骨颈骨折合并骨质疏松患者的临床效果。方法 前瞻性收集2010 年1 月至2012 年12 月期间大连大学附属中山医院收治的符合纳入及排除标准的全髋关节置换手术治疗老年股骨颈骨折合并骨质疏松的患者30 例(30 髋),随机分为A 组(普通生物型髋关节假体,15 例15 髋)和B 组(钽涂层髋关节假体,15 例15 髋)。分别于术后6 个月、12 个月、36 个月时随访并比较两组患者手术时间、术中出血量、平均住院日及术后负重时间。采用Harris 评分评估髋关节功能,根据DeLee 和Charnley 法及Gruen 分区评估髋关节假体的稳定性。结果 所有患者均获得成功随访,随访时间36 ~ 64 个月,平均(48±9)个月。两组患者的手术时间、术中出血量、平均住院日及术后开始负重时间比较差异均无统计学意义(P > 0.05)。B组在术后12 个月、36 个月的Harris 评分明显高于A组,差异具有统计学意义(F=?2.483, P < 0.05;F=?2.412,P < 0.05)。A 组患者有3 例在术后36 个月出现骨溶解,1 例术后49 个月出现股骨假体的松动;B 组患者均未出现溶骨性改变及假体松动、下沉,所有患者股骨假体均骨性固定,髋臼假体均稳定固定。结论 多孔钽涂层髋关节假体可改善髋关节功能,增强假体的稳定性,减少假体下沉等并发症的发生,是治疗老年股骨颈骨折合并骨质疏松的较好选择。
Abstract:
Objective To investigate the efficacy of hip implants by using porous tantalum coating in the treatment of elderly femoral neck fractures with osteoporosis patients. Methods A prospective study of 30 cases (30 hips) of elderly femoral neck fractures with osteoporosis patients who underwent total hip arthroplasty in Dalian University Affiliated Zhongshan Hospital from January 2010 to December 2012. The patients were divided into two groups by the operation methods: Group A, 15 cases (15 hips) accepted ordinary cementless hip implants; Group B, 15 cases (15 hips) accepted hip implants by using porous tantalum coating. Follow ups were performed at 6 months, 12 months, 36 months after the operation. Operation time, intraoperative bleeding, average of stay in hospital, time to weight bearing were compared between the two groups. According to Harris hip score, functioning hips of the two groups were evaluated. Evaluation of hip prosthesis stability based on DeLee and Charnley and Gruen partitioning. Results All patients were followed up for 36 to 64 months, with an average of 48±9 months. Harris score for hip function was significantly better in Group B than Group A at 12 months and 36 months postoperation (F=?2.483, P<0.05; F=?2.412, P<0.05). In Group A, three cases affected osteolysis at 36 months and one case experienced prosthesis loosening at 49 months after arthroplasty. In Group B, imaging examination showed that bone ingrowth of the femoral prosthesis and stability of acetabular prosthesis were observed in all patients, no osteolytic lesion, no sinking or loosening. Conclusions Hip prosthesis by using porous tantalum coating can achieve early bone ingrowth, enhance the stability, and decrease the incidence of complications such as prosthesis sinking. It is a good choice for the treatment of elderly femoral neck fractures with osteoporosis patients.

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备注/Memo

备注/Memo:
十二五国家科技支撑计划项目(2012BAI17B02)
更新日期/Last Update: 2016-05-17