Templeton J E, Callaghan J J, Goetz D D, Sullivan P M, Johnston R C
The University of Iowa College of Medicine, Iowa City, 52242, USA.
J Bone Joint Surg Am. 2001 Nov;83(11):1706-11. doi: 10.2106/00004623-200111000-00014.
Although cementless acetabular components are routinely used in revision hip surgery, few investigators have evaluated the retention and efficacy of these components in the long term. In the current study, the clinical and radiographic outcomes of a series of arthroplasties performed by one surgeon with a cementless acetabular component were assessed at a minimum of ten years.
From 1986 through 1988, sixty-one consecutive revision total hip arthroplasties were performed in fifty-five patients because of aseptic failure of one or both components of a prosthesis in which both components had been cemented. Twenty-eight patients (thirty-two hips) were alive at a mean of 12.9 years (range, 11.5 to 14.3 years) after the operation. In all of the patients, the acetabular component was revised to a porous-coated Harris-Galante component inserted without cement, and the femoral component was revised to an Iowa component affixed with contemporary cementing techniques. The hips were evaluated clinically and radiographically at a minimum of ten years subsequent to the index revision. No hips were lost to follow-up.
None of the acetabular components required revision because of aseptic loosening. Two hips (3%) demonstrated radiographic evidence of aseptic loosening of the acetabular component. The polyethylene liner was exchanged during the follow-up period in eight hips.
After a minimum of ten years of follow-up, cementless acetabular fixation in revision hip arthroplasty had produced durable results that were markedly better than those reported for acetabular fixation with cement.
尽管在髋关节翻修手术中无骨水泥髋臼假体已被常规使用，但很少有研究者对这些假体的长期留存率和疗效进行评估。在本研究中，对由同一位外科医生使用无骨水泥髋臼假体进行的一系列关节成形术的临床和影像学结果进行了至少十年的评估。
从1986年至1988年，因假体的一个或两个组件无菌性失效，对55例患者连续进行了61例全髋关节翻修手术，最初的假体两个组件均使用骨水泥固定。术后平均12.9年（范围为11.5至14.3年）时，28例患者（32髋）仍存活。所有患者的髋臼假体均翻修为无骨水泥植入的多孔涂层Harris-Galante假体，股骨假体翻修为采用当代骨水泥技术固定的Iowa假体。在初次翻修术后至少十年对髋关节进行临床和影像学评估。无髋关节失访。
无髋臼假体因无菌性松动而需要翻修。两髋（3%）出现髋臼假体无菌性松动的影像学证据。随访期间有8髋更换了聚乙烯内衬。
经过至少十年的随访，髋关节翻修术中无骨水泥髋臼固定产生了持久的效果，明显优于有骨水泥髋臼固定的报道结果。
