采用高交聯聚乙烯與傳統聚乙烯髖臼內襯行人工全髖關節置換的比較研究_《中國修復重建外科雜志》

作者：

魏召勸 , 孫俊英 , 查國春 , 董圣杰 , 王濤 , 方遠

蘇州大學附屬第一醫院骨科（江蘇蘇州，215006）;

關鍵詞：

人工全髖關節置換髖臼內襯高交聯聚乙烯骨溶解

DOI：

10.7507/1002-1892.20130310

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目的比較采用高交聯聚乙烯與傳統聚乙烯髖臼內襯行人工全髖關節置換（total hip arthroplasty，THA）術后髖臼內襯線性磨損程度及療效。方法回顧分析2005年1月－2007年3月61例（64髖）行初次THA患者的臨床資料，其中30例（31髖）采用高交聯聚乙烯髖臼內襯（試驗組），31例（33髖）采用傳統聚乙烯髖臼內襯（對照組）。兩組患者性別、年齡、體重、病因及術前Harris評分比較，差異均無統計學意義（P gt; 0.05）。記錄術后并發癥發生情況，采用Harris評分評定髖關節功能。攝X線片觀察假體周圍骨溶解及假體松動情況，測量股骨頭累積穿透位移值及線性磨損率。結果術后患者切口均Ⅰ期愈合，無早期并發癥發生。兩組患者均獲隨訪，試驗組隨訪時間為5～7年，平均6.3年；對照組為4～7年，平均6.5年。兩組術后3個月及末次隨訪時Harris評分比較，差異均無統計學意義（P gt; 0.05）。對照組3例（3髖）發生骨溶解，試驗組無骨溶解發生；兩組均未出現假體松動。術后1～7年試驗組股骨頭累積穿透位移值均低于對照組，差異有統計學意義（P lt; 0.05）。試驗組線性磨損率為（0.025 ± 0.002）mm/年，顯著低于對照組的（0.086 ± 0.005） mm/年（Z=6.804，P=0.000）。結論采用高交聯聚乙烯髖臼內襯行THA的療效與傳統聚乙烯髖臼內襯相似，但具有更好的抗磨損性能。

引用本文： 魏召勸,孫俊英,查國春,董圣杰,王濤,方遠. 采用高交聯聚乙烯與傳統聚乙烯髖臼內襯行人工全髖關節置換的比較研究. 中國修復重建外科雜志, 2013, 27(12): 1414-1418. doi: 10.7507/1002-1892.20130310 復制

1.	孫俊英. 人工髖關節翻修手術學. 北京: 人民軍醫出版社, 2012: 4-18.
2.	Harris WH. The problem is osteolysis. Clin Orthop Relat Res, 1995, (311): 46-53.
3.	Gallo J, Havranek V, Zapletalova J. Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty. Int Orthop, 2010, 34(1): 19-26.
4.	Grobbelaar CJ, du Plessis TA, Marais F. The radiation improvement of polyethylene prostheses. A preliminary study. J Bone Joint Surg (Br), 1978, 60-B(3): 370-374.
5.	DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121): 20-32.
6.	Zicat B, Engh CA, Gokcen E. Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg (Am), 1995, 77(3): 432-439.
7.	Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A(9): 1333-1338.
8.	Engh CA Jr, Culpepperii WJ 2nd, Engh CA. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg (Am), 1997, 79(2): 177-184.
9.	戴雪松, 嚴世貴, 潘志軍, 等. 全髖關節置換術后聚乙烯內襯磨損的測量及其臨床意義. 中華骨科雜志, 2001, 21(4): 229-232.
10.	Martell JM, Berdia S. Determination of polyethylene wear in total hip replacements with use of digital radiographs. J Bone Joint Surg (Am), 1997, 79(11): 1635-1641.
11.	Shaver SM, Brown TD, Hillis SL, et al. Digital edge-detection measurement of polyethylene wear after total hip arthroplasty. J Bone Joint Surg (Am), 1997, 79(5): 690-700.
12.	Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty, 2002, 17(5): 649-661.
13.	Engh CA Jr, Hopper RH Jr, Huynh C, et al. A prospective, randomized study of cross-linked and non-cross-linked polyethylene for total hip arthroplasty at 10-year follow-up. J Arthroplasty, 2012, 27(8 Suppl): 2-7. e1.
14.	Dorr LD, Wan Z, Shahrdar C, et al. Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg (Am), 2005, 87(8): 1816-1821.
15.	Calvert GT, Devane PA, Fielden J, et al. A double-blind, prospective, randomized controlled trial comparing highly cross-linked and conventional polyethylene in primary total hip arthroplasty. J Arthroplasty, 2009, 24(4): 505-510.
16.	Rajadhyaksha AD, Brotea C, Cheung Y, et al. Five-year comparative study of highly cross-linked (crossfire) and traditional polyethylene. J Arthroplasty, 2009, 24(2): 161-167.
17.	Olyslaegers C, Defoort K, Simon JP, et al. Wear in conventional and highly cross-linked polyethylene cups: a 5-year follow-up study. J Arthroplasty, 2008, 23(4): 489-494.
18.	Geerdink CH, Grimm B, Vencken W, et al. Cross-linked compared with historical polyethylene in THA: an 8-year clinical study. Clin Orthop Relat Res, 2009, 467(4): 979-984.
19.	Wroblewski BM, Siney PD, Fleming PA. Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene. A ten-year follow-up report. J Bone Joint Surg (Br), 1999, 81(1): 54-55.
20.	Bradford L, Baker D, Ries MD, et al. Fatigue crack propagation resistance of highly cross-linked polyethylene. Clin Orthop Relat Res, 2004, (429): 68-72.

1. 孫俊英. 人工髖關節翻修手術學. 北京: 人民軍醫出版社, 2012: 4-18.
2. Harris WH. The problem is osteolysis. Clin Orthop Relat Res, 1995, (311): 46-53.
3. Gallo J, Havranek V, Zapletalova J. Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty. Int Orthop, 2010, 34(1): 19-26.
4. Grobbelaar CJ, du Plessis TA, Marais F. The radiation improvement of polyethylene prostheses. A preliminary study. J Bone Joint Surg (Br), 1978, 60-B(3): 370-374.
5. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res, 1976, (121): 20-32.
6. Zicat B, Engh CA, Gokcen E. Patterns of osteolysis around total hip components inserted with and without cement. J Bone Joint Surg (Am), 1995, 77(3): 432-439.
7. Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A(9): 1333-1338.
8. Engh CA Jr, Culpepperii WJ 2nd, Engh CA. Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg (Am), 1997, 79(2): 177-184.
9. 戴雪松, 嚴世貴, 潘志軍, 等. 全髖關節置換術后聚乙烯內襯磨損的測量及其臨床意義. 中華骨科雜志, 2001, 21(4): 229-232.
10. Martell JM, Berdia S. Determination of polyethylene wear in total hip replacements with use of digital radiographs. J Bone Joint Surg (Am), 1997, 79(11): 1635-1641.
11. Shaver SM, Brown TD, Hillis SL, et al. Digital edge-detection measurement of polyethylene wear after total hip arthroplasty. J Bone Joint Surg (Am), 1997, 79(5): 690-700.
12. Dumbleton JH, Manley MT, Edidin AA. A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplasty, 2002, 17(5): 649-661.
13. Engh CA Jr, Hopper RH Jr, Huynh C, et al. A prospective, randomized study of cross-linked and non-cross-linked polyethylene for total hip arthroplasty at 10-year follow-up. J Arthroplasty, 2012, 27(8 Suppl): 2-7. e1.
14. Dorr LD, Wan Z, Shahrdar C, et al. Clinical performance of a Durasul highly cross-linked polyethylene acetabular liner for total hip arthroplasty at five years. J Bone Joint Surg (Am), 2005, 87(8): 1816-1821.
15. Calvert GT, Devane PA, Fielden J, et al. A double-blind, prospective, randomized controlled trial comparing highly cross-linked and conventional polyethylene in primary total hip arthroplasty. J Arthroplasty, 2009, 24(4): 505-510.
16. Rajadhyaksha AD, Brotea C, Cheung Y, et al. Five-year comparative study of highly cross-linked (crossfire) and traditional polyethylene. J Arthroplasty, 2009, 24(2): 161-167.
17. Olyslaegers C, Defoort K, Simon JP, et al. Wear in conventional and highly cross-linked polyethylene cups: a 5-year follow-up study. J Arthroplasty, 2008, 23(4): 489-494.
18. Geerdink CH, Grimm B, Vencken W, et al. Cross-linked compared with historical polyethylene in THA: an 8-year clinical study. Clin Orthop Relat Res, 2009, 467(4): 979-984.
19. Wroblewski BM, Siney PD, Fleming PA. Low-friction arthroplasty of the hip using alumina ceramic and cross-linked polyethylene. A ten-year follow-up report. J Bone Joint Surg (Br), 1999, 81(1): 54-55.
20. Bradford L, Baker D, Ries MD, et al. Fatigue crack propagation resistance of highly cross-linked polyethylene. Clin Orthop Relat Res, 2004, (429): 68-72.

《中國修復重建外科雜志》

采用高交聯聚乙烯與傳統聚乙烯髖臼內襯行人工全髖關節置換的比較研究

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《中國修復重建外科雜志》

采用高交聯聚乙烯與傳統聚乙烯髖臼內襯行人工全髖關節置換的比較研究

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