Tennent T D, Goddard N J
Orthopaedic Department, Royal Free Hospital NHS Trust, London, UK.
Ann R Coll Surg Engl. 2000 Jan;82(1):33-8.
A postal questionnaire was sent to all practicing consultant orthopaedic surgeons in the UK seeking information regarding their usual total hip replacement practice, the age at which they would define a patient as falling into the 'young hip group' and whether this might modify their practice. In particular, in the 'younger' age group, we were interested in the frequency of usage of uncemented implants, the choice of implant and the bearing surfaces. Of 1242 surgeons surveyed, we had a response from 935 who currently undertake total hip arthroplasty. Their responses confirm that approximately 60,645 total hip replacements are performed annually in the UK of which 9,376 are performed in the younger age group (mean age 57.5 years). As with our previous survey, the most popular prosthesis in the 'older' age group overall was the Charnley (51%) followed by the Exeter (15%). These implants also proved to be the most popular in the 'younger' age group (40% Charnley, 18% Exeter), with 75% of surgeons choosing a cemented stem, and 65% also opting to cement the socket. 23% of surgeons used hydroxy-apatite coated implants on both the femoral and acetabular sides of the joint. Stainless steel remained the most popular choice of femoral head bearing surface (42%) followed by chrome-cobalt (33%) and ceramic (25%). On the acetabular side, high density polyethylene predominated--accounting for 95%, with only 3% using chrome cobalt and 2% ceramic. There would appear to be a remarkably conservative attitude among British surgeons, the majority of whom prefer to stick with tried and tested cemented femoral implants when dealing with the younger patient. There are a small number of uncemented acetabulae and the hybrid configuration. Hydroxy-apatite coatings seem to be the most popular choice for the non-cemented prostheses. Ceramic femoral heads are used more frequently than the ceramic acetabular bearing, and equally metal/metal bearings remain infrequently used.
我们向英国所有执业的骨科顾问医生发送了一份邮政调查问卷，以获取有关他们常规全髋关节置换手术的信息，他们将患者定义为“年轻髋关节组”的年龄，以及这是否会改变他们的手术方式。特别是在“较年轻”年龄组中，我们对非骨水泥型植入物的使用频率、植入物的选择和关节面感兴趣。在接受调查的1242名外科医生中，有935名目前进行全髋关节置换术的医生给予了回复。他们的回复证实，英国每年大约进行60,645例全髋关节置换手术，其中9376例在较年轻年龄组（平均年龄57.5岁）进行。与我们之前的调查一样，“老年”年龄组中最受欢迎的假体总体上是Charnley型（51%），其次是Exeter型（15%）。这些植入物在“较年轻”年龄组中也被证明是最受欢迎的（Charnley型占40%，Exeter型占18%），75%的外科医生选择骨水泥型股骨柄，65%的医生也选择对髋臼进行骨水泥固定。23%的外科医生在关节的股骨侧和髋臼侧都使用了羟基磷灰石涂层植入物。不锈钢仍然是股骨头关节面最受欢迎的选择（42%），其次是铬钴合金（33%）和陶瓷（25%）。在髋臼侧，高密度聚乙烯占主导地位——占95%，只有3%的医生使用铬钴合金，2%的医生使用陶瓷。英国外科医生似乎持有非常保守的态度，他们中的大多数人在处理较年轻患者时更喜欢坚持使用经过试验和测试的骨水泥型股骨植入物。有少数非骨水泥型髋臼和混合型配置。羟基磷灰石涂层似乎是非骨水泥型假体最受欢迎的选择。陶瓷股骨头的使用频率高于陶瓷髋臼关节面，同样金属/金属关节面仍然很少使用。
