■这项研究的目的是评估功能结果,放射学结果,股骨头软骨下功能不全骨折(SIFs)患者混合全髋关节置换术(THA)后的并发症。
■从2009年6月到2020年12月,在我们医院接受混合THA的985名患者中,包括通过回顾性图表回顾诊断为SIF的19例患者。那些50岁以下的人,在手术的对侧有骨坏死的影像学表现,器官移植史,酗酒,被排除在外。使用改良的Harris髋关节评分(HHS)进行功能评估。手术后,使用术后X线测量髋臼杯的倾斜和前倾以及股骨系统的版本。6周时进行门诊随访,3个月,9个月,手术后12个月和之后的每一年。并发症包括脱位,植入物松动,茎沉陷,随访X线片观察到假体周围感染。
■平均随访时间为29.3±9.1个月(范围,24-64个月),随访无损失。平均改良HHS为83.4±9.6(范围,65-100)在最后一次门诊随访中。髋臼杯的平均倾斜度为41.9°±3.4°(范围,37°-48°),前倾为27.5°±6.7°(范围,18°-39°)。股骨柄的版本为19°±5.7°(范围,12°-29°)。术中无骨折病例。没有脱臼的病例,松开杯子,股骨干下沉,术中或假体周围骨折,或随访X线片上的假体周围感染。
■在我们的研究中,混合THA在诊断为SIF的患者中显示出良好的预后,对于由于其他疾病或骨折而进行的THA,没有进一步的特殊考虑。
UNASSIGNED: The purpose of this study was to evaluate functional outcomes, radiologic results, and complications after hybrid total hip arthroplasty (THA) in patients with subchondral insufficiency fractures (SIFs) of the femoral head.
UNASSIGNED: From June 2009 to December 2020, among 985 patients who underwent hybrid THA at our hospital, 19 patients diagnosed with SIF through a retrospective chart review were included. Those under 50 years of age, with radiographic findings of osteonecrosis on the contralateral side of surgery, a history of organ transplantation, and alcohol abuse, were excluded. Functional evaluation was performed using a modified Harris Hip Score (HHS). After surgery, inclination and anteversion of the acetabular cup and version of the femoral system were measured using postoperative x-ray. The outpatient follow-up was performed at 6 weeks, 3 months, 9 months, and 12 months after surgery and every year thereafter. Complications including dislocation, implant loosening, stem subsidence, and periprosthetic infection were observed on follow-up radiographs.
UNASSIGNED: The average follow-up time was 29.3 ± 9.1 months (range, 24-64 months) with no loss to follow-up. The mean modified HHS was 83.4 ± 9.6 (range, 65-100) at the last outpatient clinic follow-up. The average inclination of the acetabular cup was 41.9° ± 3.4° (range, 37°-48°), and the anteversion was 27.5° ± 6.7° (range, 18°-39°). The version of the femoral stem was 19° ± 5.7° (range, 12°-29°). There was no case of intraoperative fracture. There were no cases of dislocation, loosening of the cup, subsidence of the femoral stem, intraoperative or periprosthetic fracture, or periprosthetic infection on the follow-up radiographs.
UNASSIGNED: In our study, hybrid THA showed favorable outcomes in patients diagnosed with SIF, and there were no further special considerations as for THA performed due to other diseases or fractures.