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75岁以上患者中骨水泥型全聚乙烯髋臼组件的长期生存率。

Long-term survivorship of cemented all-polyethylene acetabular components in patients > 75 years of age.

作者信息

Levy B A, Berry D J, Pagnano M W

机构信息

Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

J Arthroplasty. 2000 Jun;15(4):461-7. doi: 10.1054/arth.2000.4340.

Abstract

Between 1974 and 1982, 132 consecutive hips in 112 patients >75 years of age were treated with primary total hip arthroplasty for osteoarthritis using a cemented all-polyethylene T28 socket and cemented T28 or TR28 stem with a 28-mm head size. At the time of review, 94 patients (110 hips [83%]) had died and 18 patients (22 hips [17%]) were still living (mean age at follow-up, 93 years). Five hips (5 patients) were lost to follow-up. Clinical follow-up averaged 8.9 years for the entire group and 14.6 years for patients still living. Only 2 acetabular components have been revised (1 for recurrent dislocation, 1 for infection). No acetabular component has required revision for aseptic loosening. Survivorship free of acetabular revision for aseptic loosening at 10 years was 100%; free of symptomatic acetabular loosening, 97.4% (95% confidence interval, 91.8-100%); and free of acetabular loosening, 95.9% (95% confidence interval, 89.7-100%). The commonest complication was postoperative hip dislocation, which occurred in 11 hips (8.7%) and which required reoperation in 2 hips. Cemented acetabular components implanted in patients >75 years of age with a diagnosis of osteoarthritis showed a high rate of survivorship free of revision and free of symptomatic aseptic loosening.

摘要

1974年至1982年间,对112例75岁以上因骨关节炎接受初次全髋关节置换术的患者的132个髋关节,使用骨水泥固定的全聚乙烯T28髋臼杯以及骨水泥固定的T28或TR28股骨柄和28毫米股骨头进行治疗。在复查时,94例患者(110个髋关节[83%])已死亡,18例患者(22个髋关节[17%])仍在世(随访时的平均年龄为93岁)。5个髋关节(5例患者)失访。整个组的临床随访平均为8.9年,仍在世患者的随访平均为14.6年。仅2个髋臼部件进行了翻修(1例因复发性脱位,1例因感染)。没有髋臼部件因无菌性松动而需要翻修。10年时无无菌性松动髋臼翻修的生存率为100%;无症状髋臼松动的生存率为97.4%(95%置信区间,91.8 - 100%);无髋臼松动的生存率为95.9%(95%置信区间,89.7 - 100%)。最常见的并发症是术后髋关节脱位,发生在11个髋关节(8.7%),其中2个髋关节需要再次手术。植入75岁以上诊断为骨关节炎患者的骨水泥固定髋臼部件显示出无需翻修和无症状无菌性松动的高生存率。

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