目的探讨人工髋关节表面置换术（hip resurfacing arthroplasty，HRA）治疗年龄<60岁中青年股骨头坏死患者的临床疗效。 方法2008年1月－2009年4月采用HRA治疗股骨头坏死患者34例，其中男19例，女15例；左髋16例，右髋18例；年龄33～59岁，平均54岁。病因：酒精性9例，激素性8例，创伤性7例，不明原因10例。病程2～11年，平均5年。股骨头坏死改良Ficat分期为Ⅲ期26例，Ⅳ期8例。采用Harris髋关节评分系统（Harris hip score，HHS）和改良加州大学洛杉矶分校（UCLA）活动评分评估患者临床效果；术后摄X线片评估假体位置及是否发生松动，并测量臼杯外展角、颈干角和股骨假体-股骨外侧皮质长度比判断术后有无股骨头假体塌陷。 结果术后患者切口均Ⅰ期愈合，无切口感染、下肢深静脉血栓形成等术后早期并发症发生。32例患者获随访，随访时间70～84个月，平均78个月。随访期间均无假体松动、感染、股骨颈骨折、脱位及炎性假瘤等并发症发生。末次随访时患者HHS评分和改良UCLA活动评分分别为（95.22±1.47）、（7.70±1.13）分，均显著优于术前的（50.10±2.27）、（3.90±0.90）分，比较差异均有统计学意义（t=1.510，P=0.008；t=0.830，P=0.003）。术后3 d与末次随访时比较患者臼杯外展角、颈干角及股骨假体-股骨外侧皮质长度比，差异均无统计学意义（P>0.05）。 结论严格掌握手术指征，HRA可作为治疗中青年Ficat Ⅲ期或Ⅳ期股骨头坏死患者的有效方法
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