SHORT-AND MEDIUM-TERM EFFECTIVENESSES OF STEMLESS HIP ARTHROPLASTY FOR TREATING HIP JOINT DISEASE IN YOUNG AND MIDDLE-AGED PATIENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 CHENQingzhen ¹ , LIUWuyang ² , GAOHui ² , SHIMingxiang ¹ , LIANYucai ¹

1. Department of Orthopaedics, Ganzhou Hospital of Traditional Chinese Medicine, Ganzhou Jiangxi, 341000, P. R. China;
2. Department of Orthopaedics, the First Affiliated Hospital of Gannan Medical University;

Corresponding?author：

CHENQingzhen, Email: cfeng0608@163.com

Keywords：

Stemless hip prosthesis; Total hip arthroplasty; Hip joint disease; Young and middle-aged patients

DOI：

10.7507/1002-1892.20140232

Video：

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Objective To summarize the short-and medium-term effectivenesses of stemless hip arthroplasty for treating hip joint disease in young and middle-aged patients. Methods Between June 2005 and December 2010, 25 cases (27 hips) of hip joint disease were treated with stemless hip arthroplasty. There were 17 males (19 hips) and 8 females (8 hips) with an average age of 45.6 years (range, 30-57 years), including 13 left hips, 10 right hips, and 2 bilateral hips. The causes included avascular necrosis of the femoral head (ANFH) secondary to femoral neck fracture in 5 cases (5 hips), ANFH in 15 cases (16 hips), osteoarthritis of the hip joint caused by ankylosing spondylitis in 2 cases (3 hips), osteoarthritis of the hip joint caused by dysplasia of acetabular in 2 cases (2 hips), and rheumatoid arthritis in 1 case (1 hip). The disease duration was 1-17 years (mean, 6.1 years). Before operation, the Harris score was 47.6±14.2. Results The incision healed by first intention in all patients, and no complications occurred, such as infection, periprosthetic fracture, and deep vein thrombosis of lower extremity. Twenty-five patients (27 hips) were followed up 36-96 months (mean, 51 months). One case (1 hip) had sciatic nerve injury after operation, which was relieved by symptomatic treatment. One case (1 hip) had prosthesis loosening, which was relieved after revision. The survival rate of prosthesis was 96.3% (26/27). At last follow-up, the Harris score was 92.1±3.6, which was significantly better than preoperative score (t=18.241, P=0.000). The excellent and good rate was 88.9% (excellent in 19 hips, good in 5 hips, fair in 2 hips, and poor in 1 hip). The X-ray films showed good location of prosthesis, and no evidence of dislocation, bone resorption, osteolysis, and heterotopic ossification. Conclusion Because of reserving femoral neck, biomechanics conduction and distribute of the proximal femur achieve natural biomechanics state of the human body. The short-and medium-term effectivenesses of stemless hip arthroplasty for treating hip joint disease in young and middle-aged patients are satisfactory, but the long-term effectiveness need further observation.

Citation： CHENQingzhen, LIUWuyang, GAOHui, SHIMingxiang, LIANYucai. SHORT-AND MEDIUM-TERM EFFECTIVENESSES OF STEMLESS HIP ARTHROPLASTY FOR TREATING HIP JOINT DISEASE IN YOUNG AND MIDDLE-AGED PATIENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(9): 1062-1065. doi: 10.7507/1002-1892.20140232 Copy

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5.	Koo KH, Ha YC, Jung WH, et al.Isolated fracture of the ceramic head after third-generation alumina-on-alumina total hip arthroplasty.J Bone Joint Surg (Am), 2008, 90(2):329-336.
6.	姜文學, 尤佳, 李軼津, 等.髖關節表面置換術的近期療效及其并發癥分析.中華骨科雜志, 2009, 29(9):858-863.
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11.	沈彬, 黃強, 楊靜, 等.全髖關節表面置換術治療髖關節發育不良繼發骨關節炎的早期療效觀察.中華骨科雜志, 2010, 30(4):357-362.
12.	尤瑞金, 鄭文忠, 陳昆, 等.保留股骨頸人工全髖關節置換術后5年以上隨訪的臨床療效.實用骨科雜志, 2013, 19(8):702-704, 738.
13.	Byrd JW, Jones KS.Hip arthroscopy in the presence of dysplasia.Arthroscopy, 2003, 19(10):1055-1060.
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15.	錢本文.無柄髖關節才是真微創(MIS).中國矯形外科雜志, 2006, 14(3):174-176.
16.	費琴明, 洪水棕, 陳統一, 等.無柄解剖形人工髖關節生物力學實驗研究.生物醫學工程學雜志, 2005, 22(1):104-107.
17.	錢齊榮, 茍三懷, 黃國富, 等.新型無柄人工髖關節生物固定的臨床組織學研究.中華臨床醫藥, 2003, 4(2):11-14.
18.	Randelli F, Banci L, D'Anna A, et al.Cemenfless Metasul metal-on-metal total hip arthroplasties at 13 years.J Arthroplasty, 2012, 27(2):186-192.
19.	楊峰, 徐衛東, 趙金柱, 等.改進型Tri-lock骨保留假體的短期臨床應用研究.中華關節外科雜志(電子版), 2014, 8(1):38-44.
20.	許偉華, 劉先哲, 張波, 等.短柄全髖關節置換術治療中青年股骨頭壞死患者的近期療效.中華骨科雜志, 2013, 33(3):200-205.
21.	何志勇, 狄正林, 曾智敏, 等.金屬對金屬全髖關節表面置換術的近期療效.中華骨科雜志, 2012, 32(6):533-538.
22.	范梓航, 姚進, 劉凱, 等.無柄人工髖關節置換26例臨床報告.中國矯形外科雜志, 2009, 17(19):1512-1514.

1. Liu YE, Hu S, Chan SP, et al.The epidemiology and surgical outcomes of patients undergoing primary total hip replacement:an Asian perspective.Singapore Med J, 2009, 50(1):15-19.
2. 丁少華, 鄭慷.保留股骨頸型人工全髖關節置換術治療中青年髖關節疾病.中國修復重建外科雜志, 2010, 24(1):1-4.
3. Malchau H, Herherts P, Eisler T, et al.The Swedish total hip replacement register.J Bone Joint Surg (Am), 2002, 84-A Suppl 2:2-20.
4. Landor I, Vavrík P, Jahoda D.General principles of infection treatment in joint replacements.Acta Chir Orthop Traumatol Cech, 2005, 72(3):183-190.
5. Koo KH, Ha YC, Jung WH, et al.Isolated fracture of the ceramic head after third-generation alumina-on-alumina total hip arthroplasty.J Bone Joint Surg (Am), 2008, 90(2):329-336.
6. 姜文學, 尤佳, 李軼津, 等.髖關節表面置換術的近期療效及其并發癥分析.中華骨科雜志, 2009, 29(9):858-863.
7. 郝鵬, 裴福興, 沈彬, 等.全髖關節表面置換治療成人先天性髖關節發育不良與近期療效.中國矯形外科雜志, 2006, 14(23):1787-1791.
8. 楊述華, 許偉華, 葉樹楠, 等.全髖關節表面置換術的近期療效觀察.中國矯形外科雜志, 2009, 17(19):1452-1454.
9. Crawford R, Ranawat CS, Rothman RH.Metal on metal:is it worth the risk? J Arthroplasty, 2010, 25(1):1-2.
10. Amstutz HC, Le Duff MJ, Campbell PA, et al.Clinical and radiographic results of metal-on-metal hip resurfacing with a minimum ten-year follow-up.J Bone Joint Surg (Am), 2010, 92(16):2663-2671.
11. 沈彬, 黃強, 楊靜, 等.全髖關節表面置換術治療髖關節發育不良繼發骨關節炎的早期療效觀察.中華骨科雜志, 2010, 30(4):357-362.
12. 尤瑞金, 鄭文忠, 陳昆, 等.保留股骨頸人工全髖關節置換術后5年以上隨訪的臨床療效.實用骨科雜志, 2013, 19(8):702-704, 738.
13. Byrd JW, Jones KS.Hip arthroscopy in the presence of dysplasia.Arthroscopy, 2003, 19(10):1055-1060.
14. 林月秋, 徐永清, 柏利, 等.無柄人工髖關節置換術的初步臨床應用.中華骨科雜志, 2010, 30(6):554-557.
15. 錢本文.無柄髖關節才是真微創(MIS).中國矯形外科雜志, 2006, 14(3):174-176.
16. 費琴明, 洪水棕, 陳統一, 等.無柄解剖形人工髖關節生物力學實驗研究.生物醫學工程學雜志, 2005, 22(1):104-107.
17. 錢齊榮, 茍三懷, 黃國富, 等.新型無柄人工髖關節生物固定的臨床組織學研究.中華臨床醫藥, 2003, 4(2):11-14.
18. Randelli F, Banci L, D'Anna A, et al.Cemenfless Metasul metal-on-metal total hip arthroplasties at 13 years.J Arthroplasty, 2012, 27(2):186-192.
19. 楊峰, 徐衛東, 趙金柱, 等.改進型Tri-lock骨保留假體的短期臨床應用研究.中華關節外科雜志(電子版), 2014, 8(1):38-44.
20. 許偉華, 劉先哲, 張波, 等.短柄全髖關節置換術治療中青年股骨頭壞死患者的近期療效.中華骨科雜志, 2013, 33(3):200-205.
21. 何志勇, 狄正林, 曾智敏, 等.金屬對金屬全髖關節表面置換術的近期療效.中華骨科雜志, 2012, 32(6):533-538.
22. 范梓航, 姚進, 劉凱, 等.無柄人工髖關節置換26例臨床報告.中國矯形外科雜志, 2009, 17(19):1512-1514.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-AND MEDIUM-TERM EFFECTIVENESSES OF STEMLESS HIP ARTHROPLASTY FOR TREATING HIP JOINT DISEASE IN YOUNG AND MIDDLE-AGED PATIENTS

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