1假体下沉的原因 人工髋关节置换术后,有一定数量的假体出现早期下沉,在初期固定和永久固定中间有一段假体下沉的距离,尤其对于生物型假体的下沉则更为常见,在应力的作用下,假体会下沉而达到一个更加稳定的位置以适应应力的变化.

目的探讨人工髋关节置换方法的选择,手术操作及术后康复训练对疗效的影响.材料与方法对18例髋关节置换术后患者进行随访,其中髋关节置换单极2例,双极10例,全髋6例,其平均随访时间为2年4个月,应用公认的Harris髋部评分系统,在疼痛、功能、活动范围和畸形4个方面进行临床检查,同时行髋部正侧位拍片检查.结果髋关节置换患者平均术前Harris评分56分,术后89.4分,优良率88.9%,有2例患者术后患肢延长约1cm,有2例双极股骨头置换患者术后Harris评分较低,髋关节拍片示随访时金属臼杯的位置与术后住院期间拍片位置发生改变.结论髋关节置换术是治疗髋部疾患的有效方法,对基础条件允许者宜行全髋置换,以避免半髋置换所致的髋臼磨损疼痛.

Objective A review of cases of congenital hip dislocation in high age children by Pemberton operation and accessory measures and investgate if the hip joint stiffness rate and ischemic necrosis rate of femoral head after operation are reduced. Methods From February 1987 to February 2000, 76 hip congenital dislocation of 58 high age children (7 years old to 14 years old) were treated by Pemberton operation and accessory measures, and were followed up from 2 years to 11 years(average, 5 years and 2 months). The accessory measures included: 1)traction of the leg for enough time with enough weight before operation, 2) immobilizing the leg by skin traction in neutral position and plank shoes instead of traditional plaster cast after operation, 3)early movement of the hip joint after operation and was allowed ambulatory late, 4) periodically the hip joint was mobilized passively. Results Six cases can only bend their hip joint below 90 degrees, accounting for 7.9% of all. 29 ischemic necrosis of femoral head occurred which accounted for 38.2%. The rate of ischemic necrosis of the femoral head and hip joint stiffness of high age children after operation were reduced obviously according to the standard by Salter. Conclusion Pemberton operation was preferred in treating the congenital hip dislocation of high age children. The accessory measures reduced the rate of ischemic necrosis of femoral head and hip joint stiffness.