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用于髋关节发育不良性骨关节炎的无骨水泥马洛里头羟基磷灰石涂层髋关节置换术

Cementless mallory-head HA-coated hip arthroplasty for osteoarthritis in hip dysplasia.

作者信息

Gosens T, van Langelaan E J, Tonino A J

机构信息

Department of Orthopaedics and Traumatology, Atrium Medical Centre, Heerlen, the Netherlands.

出版信息

J Arthroplasty. 2003 Jun;18(4):401-10. doi: 10.1016/s0883-5403(03)00063-9.

Abstract

Sixty-three cementless Mallory-Head HA-coated femoral prostheses (Biomet, Warsaw, IN) were used in primary total hip arthroplasty in 50 patients with osteoarthritic hips because of congenital hip dysplasia. The implanted cup was also cementless (41 Harris Galante and 22 Ringlock). The patients were followed up for a mean period of 75.1 months (range, 44-110). Clinical and radiologic analysis were performed. Harris Hip Score increased from 42 to 90 points; 97% of the patients had no or only mild pain, and limping decreased from 90% to 20%. Complications were marginal: no infections, one habitual dislocation, one peroperative fracture of the femur, and one transient ischiadic nerve palsy. Two HG cups were revised for augmented polyethylene wear. Radiographically, no subsidence of the prosthesis or bone atrophy of the proximal femur could be detected. No correlations were found between the radiologic phenomena and the clinical outcome, but the tightness of the prosthesis fit had a definitive influence on the radiographic bone remodeling pattern. The cementless Mallory-Head HA-coated femoral prosthesis shows excellent clinical and radiological mid-term results in osteoarthritic hip dysplasia patients. There was no need for the use of a specially designed dysplasia femoral prosthesis.

摘要

63个非骨水泥型马洛里-黑德羟基磷灰石涂层股骨假体(Biomet公司,印第安纳州华沙)用于50例因先天性髋关节发育不良导致骨关节炎性髋关节的初次全髋关节置换术。植入的髋臼杯也是非骨水泥型的(41个哈里斯·加兰特杯和22个林洛克杯)。对患者进行了平均75.1个月(范围44 - 110个月)的随访。进行了临床和影像学分析。哈里斯髋关节评分从42分提高到90分;97%的患者无疼痛或仅有轻微疼痛,跛行发生率从90%降至20%。并发症较少:无感染,1例习惯性脱位,1例术中股骨骨折,1例短暂性坐骨神经麻痹。2个哈里斯·加兰特杯因聚乙烯磨损增加而进行了翻修。影像学检查未发现假体下沉或股骨近端骨萎缩。未发现影像学表现与临床结果之间存在相关性,但假体的贴合紧密程度对影像学骨重塑模式有决定性影响。非骨水泥型马洛里-黑德羟基磷灰石涂层股骨假体在骨关节炎性髋关节发育不良患者中显示出优异的临床和影像学中期结果。无需使用专门设计的发育不良股骨假体。

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