Abstract: 【Abstract】〓Objective〓To investigate the clinical outcome of patients underwent total hip arthroplasty (THA) on the polyethylene wear of metal on polyethylene (MOP). Methods〓Between May 2003 and November 2008,.84 patients in Changshu NO.1 Hospital with MOP THA were reviewed. All patients were divided into A group (age <50 years and active patient) and B group (age≥50 and nonactive patient ) according to the age and activity. The A group received 35 patients (39 hips). The B group received 49 patients(49 hips). All prosthesis were composed by drill chromium molybdenum alloy and high-molecular-weight polyethylene..The clinicalresults were assessed by the Harris Hip Score..The radiographic results include the occurrence of bearing wear and osteolysis. The survival of the prosthesis was ended with radio graphically loosening or revision. Results〓All patients were followed up at least 5 years. In the group A, 3 cases and 3 hips (7.7%) have undergone revision but there were no revision in the group B. All the two groups have no complications like fracture, infections,.or DVT..The average Harris Hip Score of the preoperativepatients in the group A was 34.13±6.28, which improved to 91.35±2.68 postoperatively, and the Harris Hip Score in the B group was from 35.51±5.32 preoperatively to 90.05±2.47 postoperatively. The mean wear of the MOP bearing in the group A was 0.19±0.24 mm/y and which was 0.09±0.13 mm/y in the B group. There were remarkable differences in the two groups(P<0.05). Osteolysis accured in all cases in the A group, and 63.16% cases in the group B. The Osteolysis in B group significantly less than which in the A group (P<0.05). Conclusion〓There were more occurrence of bearing wear, osteolysis and the radiographical loosening in the young active patients than which in the old nonactive patients. So MOP prosthesis should be chosen carefully in the young patients.

Key words: Total hip arthroplasty, Prosthesis, MOP, Wear, Osteolysis

摘要： 【摘要】〓目的〓对金属-聚乙烯(MOP)全髋关节置换术(THA)后患者的界面磨损进行回顾性研究,探讨不同年龄段患者金属-聚乙烯全髋关节置换术的临床疗效。 方法〓收集2003年5月到2008年11月期间于常熟市第一人民医院行THA患者资料研究,共获得完整病例资料84例(88髋),按年龄及活动量分为两组:年龄<50岁和活动量大病例组(A组)和年龄≥50岁和活动量小病例组(B组)。全髋假体为钻铬钼合金-高分子聚乙烯全髋假体,临床疗效应用Harris评分标准进行临床随访和对比研究,影像学进行内衬磨损率及骨溶解测量分析。 结果〓所有病例均取的至少5年的完整随访资料,其中A组有3例3髋(7.7%)因假体松动而最终行翻修手术,而B组资料中无任何翻修病例。所有病例均未发生骨折、感染、深静脉血栓(DVT)等常见并发症。A组Harris评分由术前34.13±6.28改善至手术后91.35±2.68,B组35.51±5.32改善至90.05±2.47;影像学观察,A组内衬磨损率为每年0.19±0.24 mm,B组为每年0.09±0.13 mm,两组中MOP内衬磨损差异具有统计学意义(P<0.05);A组MOP全部发生不同程度的骨溶解,B组MOP骨溶解的发生率为63.16%,两组比较,P<0.05)。结论〓对于小于50岁和活动量大的患者,MOP假体的内衬磨损、骨溶解及影像学松动率均明显高于年龄≥50岁和活动量小的病例组,因此,对于年轻患者使用MOP假体应慎重,而对于老年病人和低活动需求的病人行THA时中期疗效较好。

关键词: 全髋关节置换术, 假体, 金属-聚乙烯, 磨损, 骨溶解