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find Author "尹一然" 3 results
  • Short-term effectiveness analysis of one-stage bilateral total hip arthroplasty by direct anterior approach

    Objective To compare the effectiveness of one-stage bilateral total hip arthroplasty by direct anterior approach (DAA) and by posterolateral approach, and to investigate the application value of DAA in one-stage bilateral total hip arthroplasty. Methods The clinical data of 65 patients who underwent one-stage bilateral total hip arthroplasty by DAA or posterolateral approach between June 2010 and November 2015 were analyzed retrospectively. DAA was used in 34 cases (group A) and posterolateral approach was used in 31 cases (group B). There was no significant difference in the gender, age, body mass index, preoperative hemoglobin level, etiology, disease duration, preoperative Harris score, and preoperative visual analogue scale (VAS) score between 2 groups (P>0.05) with comparability. The incision length, operation time, intraoperative blood loss, total blood transfusion volume, hospitalization time, early postoperative complications, Harris score, and VAS score were recorded and compared between 2 groups. The simple Likert scale method was applied to evaluate the patient satisfaction, and the imaging evaluation was used. Results The incision length, operation time, intraoperative blood loss, total blood transfusion volume, and hospitalization time of group A were significantly less than those of group B (P<0.05). The patients were followed up 15-48 months (mean, 25.3 months) in group A and 12-51 months (mean, 27.6 months) in group B. The overall incidence of complications related to surgery in group A (10.29%) was significantly lower than that of group B (19.35%) (χ2=8.769, P=0.023). The acetabular anteversion and abduction angle were in the normal range of 2 groups except 1 hip (1.47%) of group A had a higher acetabular anteversion than normal value. Unstable fixed prosthesis happened in 1 hip of groups A and B respectively, and the remaining femoral calcar had no obvious bone resorption and fixed stably. The Harris score and VAS score at each time point after operation of 2 groups were significantly improved when compared with preoperative scores (P<0.05), and the differences between the time points after operation were also significant (P<0.05). The Harris score at 1 and 3 months after operation and the VAS score at 3 days after operation of group A were significantly better than those of group B (P<0.05), but no significant difference was found at last follow-up between 2 groups (P>0.05). According to the simple Likert scale method to analyze patient satisfaction, comprehensive satisfaction of group A (97.1%, 33/34) was significantly higher than that of group B (67.7%, 21/31) (χ2=10.343, P=0.001). Conclusion The application of DAA in one-stage bilateral total hip arthroplasty can significantly relieve the pain, accelerate the recovery of hip joint function, and improve the patient satisfaction. But in clinical application, more attentions should be paid to strictly grasp the indications and prevent the early complications. The long-term effectiveness needs to be further observed.

    Release date:2017-09-07 10:34 Export PDF Favorites Scan
  • Therapeutic Effect of Arthroscopic Surgery Combined with Oral Glucosamine Hydrochloride on Osteoarthritis of the Knee

    目的 探讨关节镜手术联合口服盐酸氨基葡萄糖治疗膝骨关节炎(KOA)的近期临床疗效。 方法 选取2011年1月-12月具有关节镜手术指征的KOA患者86例,按手术顺序单双号分成两组,试验组(单号)行关节镜手术联合口服盐酸氨基葡萄糖治疗,对照组(双号)行关节镜手术治疗。采用Lequesne指数对两组患膝术前,术后第4、6周进行评分及疗效分析。 结果 两组患膝术前与术后第4、6周Lequesne指数得分比较,差异有统计学意义(P<0.05);两组术后近期疗效比较,差异有统计学意义(P<0.05)。 结论 关节镜手术联合口服盐酸氨基葡萄糖治疗KOA具有良好的近期疗效,优于单用关节镜手术治疗者。

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  • 多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效

    目的总结多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损的近期疗效。 方法回顾分析2011年3月-2014年10月,在髋关节翻修术中采用多孔钽杯联合钽金属垫块修复Paprosky Ⅲ型髋臼骨缺损的8例(8髋)患者临床资料。男3例,女5例;年龄45~78岁,平均64岁。关节置换术后1个月~12年,平均5.94年行翻修术。其中髋臼假体周围骨溶解及假体松动翻修5例,髋关节置换术后感染二期翻修3例。术前Harris评分为41~54分,平均46.25分。 结果术后患者切口均Ⅰ期愈合。8例患者均获随访,随访时间1~45个月,平均16.25个月;其中获随访1年以上3例,2年以上2例。患者术前患髋疼痛、跛行均明显改善。末次随访时,Harris评分为79~89分,平均83.75分。X线片复查示,随访期间臼杯及垫块周围未见进行性透亮线,无1例出现臼杯松动、移位及螺钉断裂,且臼杯及垫块周围有骨密度增强,骨长入良好。 结论多孔钽杯联合钽金属垫块翻修Paprosky Ⅲ型髋臼骨缺损,可保证假体良好初始稳定性及覆盖,且能实现早期骨长入,获得满意近期疗效。

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