A Two to Eleven Year Follow-Up Study of Cementless Bipolar Endoprosthesis Hip Arthroplasties

無骨泥式雙極式人工半髖關節置換術之經驗：二至十一年之追蹤研究

林榮一(Zong-I Lin) ； 林育民(Yu-Min Lin)

《中山醫學雜誌》 14卷1期 (2003/01) Pp. 1-7

https://doi.org/10.30096/CSMJ.200301.0002

摘要

本篇乃追蹤研究以無骨泥式雙極式人工半髖關節為156位患有股骨頸錯位性骨折或股骨頭缺血性壞死之病患（共162個髖關節）施行半髖關節置換手術之治療結果。本研究始於1988年1月，終於2000年12月。在研究期間，21位病人死亡，15位病人無法追蹤。總計124例髖關節（120位病人）納入本研究。股骨頭缺血性壞死及股骨頸錯位性骨折，病人手術時之平均年齡分別為47及74歲。平均追蹤時間為5.5年（範圍：2至11年）。最後追蹤時以Harris髖關節計分表評分，88%（124例髖關節中之109例）評為優或好，12%（124例髖關節中之15例）評為尚可或差。有3例髖關節脫臼，3例鬆脫，10例髖臼磨損或髖臼突出，及2例感染。合併症比率低，而且以無骨泥式雙極式人工半髖關節置換術治療後大多數病人皆可對疼痛改善度滿意。對於年輕病人患有Ficat第三級股骨頭缺血性壞死，無骨泥式雙極式人工半髖關節置換術可考慮為人工全髖關節置換術之替代手術。此外，對於股骨頸錯位性骨折，無骨泥式雙極式人工半髖關節置換術是可靠的治療方式。

關鍵字

半髖關節置換術,雙極式人工關節,股骨頭缺血性壞死,股骨頸骨折

並列摘要

This study reviewed the outcomes of 162 cementless bipolar hemiarthroplasties that were performed between January 1988 and December 2000 on 156 patients for displaced femoral neck fractures or femoral head osteonecrosis. Twenty-one patients died, and 15 were lost to follow-up. Thus, 124 hips (120 patients) were included for study. Mean patient ages at surgery for osteonecrosis and femoral neck fracture were 47 years and 74 years, respectively. Mean length of follow-up was 5.5 years (range, 2-11 years). At the last follow-up that included a Harris Hip Score evaluation, 88% (109 of 124 hips) were rated good to excellent, and 12% (15 of 124 hips) were rate fair or poor. There were 3 cases of dislocation, 3 of loosening, 10 of acetabular erosions or protrusion, and 2 of inflection. Complication rate was low, and the cementless bipolar hemiathroplasty provided satisfactory pain relief for most patients. Cementless bipolar hemiarthroplasty provides as an alternative to total hip arthroplasty in young patients with Ficat Stage III osteonecrosis and in patients with displaced femoral neck fractures.

並列關鍵字

hip hemiarthroplasty,bipolar endoprosthesis,femoral head osteonecrosis,femoral neck fracture