Meding John B, Keating E Michael, Ritter Merrill A, Faris Philip M, Berend Michael E
The Center for Hip and Knee Surgery, St Francis Hospital-Mooresville, Mooresville, IN 46158, USA.
J Bone Joint Surg Am. 2004 Jan;86(1):92-7. doi: 10.2106/00004623-200401000-00014.
The long-term results of total hip arthroplasty without cement have been reported only rarely. The purpose of the present study was to evaluate the minimum ten-year results of primary total hip arthroplasty performed with use of a proximally porous-coated, plasma-sprayed, straight-stemmed, titanium-alloy femoral component.
The clinical and radiographic results of a consecutive series of 105 total hip replacements in ninety-five patients were reviewed ten to twelve years postoperatively. The diagnosis was osteoarthritis for seventy-seven hips (73%). The clinical result was evaluated on the basis of the Harris hip score, complications, and thigh pain. A detailed radiographic analysis was performed at each follow-up visit. Kaplan-Meier analysis was performed to evaluate the survival of the femoral component.
The average Harris hip score improved from 46 points preoperatively to 92 points postoperatively. The average pain score at the time of the most recent follow-up was 42 points, with eighty-three hips (79%) rated as pain-free. Thigh pain was identified in only two patients. All radiolucent lines were seen around the tip of the stem. All hips had some degree of femoral remodeling consistent with osseous ingrowth. No femoral component was revised, and no femoral component had evidence of loosening. Eight acetabular components were revised because of loosening and wear, and one was revised because of recurrent dislocation. One focal femoral osteolytic lesion was seen.
This femoral component afforded durable fixation at ten to twelve years after primary total hip arthroplasty.
Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
非骨水泥型全髋关节置换术的长期结果鲜有报道。本研究的目的是评估使用近端多孔涂层、等离子喷涂、直柄钛合金股骨假体进行初次全髋关节置换术后至少十年的结果。
对95例患者连续进行的105例全髋关节置换术的临床和影像学结果进行了术后10至12年的回顾。77髋（73%）的诊断为骨关节炎。根据Harris髋关节评分、并发症和大腿疼痛评估临床结果。每次随访时都进行了详细的影像学分析。采用Kaplan-Meier分析评估股骨假体的生存率。
Harris髋关节平均评分从术前的46分提高到术后的92分。最近一次随访时的平均疼痛评分为42分，83髋（79%）无疼痛。仅2例患者出现大腿疼痛。所有透亮线均见于柄尖周围。所有髋关节均有一定程度的股骨重塑，与骨长入一致。无股骨假体翻修，且无股骨假体有松动迹象。8例髋臼假体因松动和磨损进行了翻修，1例因复发性脱位进行了翻修。发现1例局限性股骨溶骨病变。
该股骨假体在初次全髋关节置换术后10至12年提供了持久的固定。
治疗性研究，IV级（病例系列[无或历史性对照组]）。有关证据水平的完整描述，请参阅作者须知。
