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題 名 | Porous Coated Anatomic Total Hip Arthroplasty: 5- to 10-Year Follow Up=多重表面解剖構造全人工髖關節五至十年臨床追蹤 |
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作 者 | 楊文一; 施俊雄; | 書刊名 | 長庚醫學 |
卷 期 | 21:4 1998.12[民87.12] |
頁 次 | 頁397-402 |
分類號 | 416.61 |
關鍵詞 | 全人工髖關節置換; 無骨水泥; 多孔表面解剖構造人工關節; Total hip arthroplasty; Non-cemented; Porous coated anatomic PCA prosthesis; |
語 文 | 英文(English) |
中文摘要 | 背景:我們報告使用第一代多孔表面解剖構造(PCA)人工關節施行無骨水泥全人工 髖關節之中程結果。 方法:我們回顧本院自1985年11月至1989年3月之141位病患共161例PCA全人工髖關節臨床追 蹤5年以上病例。主要手術適應症為骨關節炎81例及缺血性壞死64例。手術時平均年齡為48 歲。追縱期從5至10年,平均6.9年。 結果:平均Modified d'Aubigen Postel髖關節評分由術前10.9進步至術後17.4。146例評分 15以上為好或極佳等級佔90.7%。12例接受再修正手術,其原因為臼杯鬆脫8例、聚乙烯磨 損1例、股骨幹端鬆脫3例。兩例接受人工髖關節拔除手術,其原因為細菌感染及結核各1例 。其它併發症包括局部骨溶解54例、後位脫臼3例、術後4年小轉子骨折1例。股部疼痛30例 佔18.6%。114例聚乙烯磨損研究發現平均磨損率為每年0.11±0.15毫米。過度年磨損率超 過0.2毫米者有28例佔20.6%。統計上高磨損率原因包括年齡較輕、臼杯傾角超過35至55度 之範圍及聚乙烯臼杯太薄。 結論:高比率之局部骨溶解及股部疼痛應警惕手術醫師對使用此種人工髖關節做審慎評估。 |
英文摘要 | Background: We report the medium term results of a study of patients with noncemented total hip arthroplasty(THA) using a first generation porous coated anatomic(PCA) prosthesis. Materials and Methods: We reviewed 161 primary uncemented PCA THAs performed in 141 patients from November 1985 through March 1989 in our hospital.Subjects were followed up for a minimum of 5 years or until revision. Most common indicators for THA were osteoarthritis in 81 hips(50.3%) and avascular necrosis in 64 hips (39.8%). The average age at operation was 48.2 years. The average follow-up period was 6.9 year in patients without revision. Results: The average modified d'Aubigne and Postel hip scores improved from 10.9 points preoperatively to 17.4 points at the final postoperative evaluation. Results were rated as good to excellent in 146 hips(90.7%). Twelve(7.4%) hips received revision arthroplasty, 8 because of cup loosening, one because of polyethylene were, and 3 hips because of stem loosening. Prostheses were removed in 2 hips, one dut to tuberculosis and the other dut to infection. Other complications included focal osteolysis in 54 hips(33.5%), posterior dislocation in 3 hips(1.9%), and lesser trochanter fracture in one hip. Thigh pain occurred in 30 hips(18.6%). In 114 hips, the roentgenograms were used to assess polyethylene wear. The average wear rate was 0.11±0.15 mm/year. Excessive wear rate(>0.2 mm/year) occurred in 28 hips(24.6%). Factors contributing to higher wear rate included young age, cup inclination angle beyond the range of 35-55°, and thin polyethylene liner. Conclusion: The high rate of osteolysis and thigh pain in these patients should alert surgeons to be cautious in using this type of prosthesis. |
本系統中英文摘要資訊取自各篇刊載內容。