Brown E C, Lachiewicz P F
Department of Orthopaedics, University of North Carolina at Chapel Hill, USA.
Clin Orthop Relat Res. 1999 Jul(364):153-9. doi: 10.1097/00003086-199907000-00020.
One hundred nineteen consecutive primary hybrid total hip arthroplasties with a precoated femoral component were performed by one surgeon in 100 patients and followed up prospectively. Ninety-eight hips in 82 patients (mean age, 67 years) were evaluated clinically and radiographically at a mean of 6.5 years (range, 5-9 years). The hips were evaluated clinically using the Harris hip score, and radiographs were evaluated for femoral cement grade, loosening, and osteolysis. Ninety-five hips remained in place at the most recent followup. Two femoral components were revised for definite loosening, and one well fixed femoral component was removed because of late hematogenous infection. Excluding the three hips that were revised, the clinical result was excellent or good in 79 hips (83%), fair in 12 hips (13%), and poor in four hips (4%). All other femoral components were well fixed. There were defects of the cement mantles (C1 and C2) in 90 hips. No femoral component had a stem and cement radiolucent line. Focal femoral osteolysis was seen in only two hips. One acetabular component was removed at 5 years because of late hematogenous infection. One acetabular component had asymptomatic migration. The remaining 96 acetabular components were well fixed. Focal acetabular osteolysis was present in four hips. The mean linear polyethylene wear rate was 0.06 (+/- 0.05) mm per year. In contrast to other reports of early failure and osteolysis, the use of a precoated femoral component in this study did not adversely affect the fixation of hybrid total hip arthroplasty, with definite failure of only 2% (two of 98) of the femoral components.
一名外科医生对100例患者连续实施了119例采用预涂股骨假体的初次混合式全髋关节置换术，并进行了前瞻性随访。对82例患者（平均年龄67岁）的98髋进行了平均6.5年（范围5 - 9年）的临床和影像学评估。采用Harris髋关节评分对髋关节进行临床评估，并对X线片进行股骨骨水泥分级、松动和骨溶解评估。在最近一次随访时，95髋假体在位。2例股骨假体因明确松动而翻修，1例固定良好的股骨假体因晚期血源性感染而取出。排除3例翻修的髋关节，79髋（83%）临床结果为优或良，12髋（13%）为一般，4髋（4%）为差。所有其他股骨假体固定良好。90髋存在骨水泥壳缺陷（C1和C2）。没有股骨假体出现柄部和骨水泥透亮线。仅2髋出现局限性股骨骨溶解。1例髋臼假体在5年后因晚期血源性感染而取出。1例髋臼假体有无症状性移位。其余96例髋臼假体固定良好。4髋存在局限性髋臼骨溶解。聚乙烯平均线性磨损率为每年0.06（±0.05）mm。与其他关于早期失败和骨溶解的报道不同，本研究中使用预涂股骨假体并未对混合式全髋关节置换术的固定产生不利影响，股骨假体明确失败率仅为2%（98例中的2例）。
