采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究_《中国修复重建外科杂志》

作者：

魏召劝 , 孙俊英 , 查国春 , 董圣杰 , 王涛 , 方远

苏州大学附属第一医院骨科（江苏苏州，215006）;

关键词：

人工全髋关节置换髋臼内衬高交联聚乙烯骨溶解

DOI：

10.7507/1002-1892.20130310

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的比较采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换（total hip arthroplasty，THA）术后髋臼内衬线性磨损程度及疗效。方法回顾分析2005年1月－2007年3月61例（64髋）行初次THA患者的临床资料，其中30例（31髋）采用高交联聚乙烯髋臼内衬（试验组），31例（33髋）采用传统聚乙烯髋臼内衬（对照组）。两组患者性别、年龄、体重、病因及术前Harris评分比较，差异均无统计学意义（P gt; 0.05）。记录术后并发症发生情况，采用Harris评分评定髋关节功能。摄X线片观察假体周围骨溶解及假体松动情况，测量股骨头累积穿透位移值及线性磨损率。结果术后患者切口均Ⅰ期愈合，无早期并发症发生。两组患者均获随访，试验组随访时间为5～7年，平均6.3年；对照组为4～7年，平均6.5年。两组术后3个月及末次随访时Harris评分比较，差异均无统计学意义（P gt; 0.05）。对照组3例（3髋）发生骨溶解，试验组无骨溶解发生；两组均未出现假体松动。术后1～7年试验组股骨头累积穿透位移值均低于对照组，差异有统计学意义（P lt; 0.05）。试验组线性磨损率为（0.025 ± 0.002）mm/年，显著低于对照组的（0.086 ± 0.005） mm/年（Z=6.804，P=0.000）。结论采用高交联聚乙烯髋臼内衬行THA的疗效与传统聚乙烯髋臼内衬相似，但具有更好的抗磨损性能。

引用本文： 魏召劝,孙俊英,查国春,董圣杰,王涛,方远. 采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究. 中国修复重建外科杂志, 2013, 27(12): 1414-1418. doi: 10.7507/1002-1892.20130310 复制

1.	孙俊英. 人工髋关节翻修手术学. 北京: 人民军医出版社, 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, 严世贵, 潘志军, 等. 全髋关节置换术后聚乙烯内衬磨损的测量及其临床意义. 中华骨科杂志, 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. 孙俊英. 人工髋关节翻修手术学. 北京: 人民军医出版社, 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, 严世贵, 潘志军, 等. 全髋关节置换术后聚乙烯内衬磨损的测量及其临床意义. 中华骨科杂志, 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.

《中国修复重建外科杂志》

采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究

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《中国修复重建外科杂志》

采用高交联聚乙烯与传统聚乙烯髋臼内衬行人工全髋关节置换的比较研究

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