人工全髋关节置换术中髋臼假体外展角大小对髋关节假体使用寿命的影响

doi:10.3969/j.issn.1671-7171.2021.04.028

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摘要 【目的】 探讨人工全髋关节置换术(THA)中髋臼假体外展角大小对髋关节假体使用寿命的影响。【方法】 选择2000年1月至2008年9月在本院行单侧THA治疗的347例患者作为研究对象,以外展角55°为截断值分为A组(外展角≥55°)和B组(＜55°),比较两组患者临床特征,单因素和多因素分析髋关节假体使用寿命的影响因素。【结果】 两组患者性别、髋部疾病类型、术前活动能力、美国麻醉医师协会(ASA)分级、手术时间、置换部位、手术入路、假体类型、术后并发症发生率比较差异均无统计学意义(P>0.05);两组患者年龄、外展角、体重指数(BMI)、髋关节假体使用寿命比较差异均有统计学意义(P<0.05)。多因素分析结果显示:外展角≥55°、年龄≥70岁、BMI≥28 kg/m²是髋关节假体使用寿命的危险因素。【结论】 髋臼外展角过大是影响THA术后患者髋关节假体寿命的危险因素,临床可辅助3D打印辅助、导向器定位等方法以提高髋臼假体定位精度,从而延长患者髋关节假体使用寿命。

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关键词 ：关节成形术,置换,髋, 髋假体/仪器和设备, 预期寿命

Abstract：【Objective】 To investigate the influence of abduction angle of acetabular prosthesis on hip joint life in total hip arthroplasty (THA). 【Methods】 A total of 347 patients with unilateral THA in our hospital from January 2010 to September 2015 were selected as the research objects. The patients were divided into group A (abduction angle ≥55°) and group B (abduction angle ＜55°) with abduction angle of 55 °as cut-off value. The clinical characteristics of the two groups were observed. The confounding factors were removed by multivariate logistic analysis. The independent correlation between abduction angle and hip joint life span was observed. 【Results】 There were no significant differences in gender, type of hip disease, preoperative activity ability, ASA grade, operation time, replacement site, surgical approach, prosthesis type and postoperative complications in patients with abduction angle ≥55° and <55° respectively (P>0.05), and there were significant differences in age, abduction angle, body mass index and prosthesis survival time between the two groups (P<0.05). Multivariate analysis showed that abduction angle ≥55 ° was a risk factor for hip joint survival. The other influencing factors included age ≥70 years old and body mass index ≥28 kg/m². 【Conclusion】 The acetabular abduction angle is a risk factor that affects the life of hip prosthesis in THA patients. Clinical methods such as 3D printing assistance and guide positioning can be assisted to improve the positioning accuracy of the acetabular prosthesis, thereby prolonging the patient's hip prosthesis service life.

Key words： Arthroplasty, Replacement, Hip Hip Prosthesis/IS Life Expectancy

收稿日期: 2021-03-02

中图分类号:

R684.75

引用本文:

殷勇, 王胜涛, 张波, 蔡杰勇, 肖波, 杨国奇, 彭得全, 张世勇, 王恒. 人工全髋关节置换术中髋臼假体外展角大小对髋关节假体使用寿命的影响[J]. 医学临床研究, 2021, 38(4): 576-578.
YIN Yong, WANG Sheng-tao, ZHANG Bo, et al. Influence of Acetabular Abduction Angle on Hip Joint Life in Total Hip Arthroplasty. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 576-578.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.04.028 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I4/576

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