Daniel J, Pynsent P B, McMinn D J W
The Birmingham Nuffield Hospital, Edgbaston, Birmingham, England, UK.
J Bone Joint Surg Br. 2004 Mar;86(2):177-84. doi: 10.1302/0301-620x.86b2.14600.
The results of conventional hip replacement in young patients with osteoarthritis have not been encouraging even with improvements in the techniques of fixation and in the bearing surfaces. Modern metal-on-metal hip resurfacing was introduced as a less invasive method of joint reconstruction for this particular group. This is a series of 446 hip resurfacings (384 patients) performed by one of the authors (DJWM) using cemented femoral components and hydroxyapatite-coated uncemented acetabular components with a maximum follow-up of 8.2 years (mean 3.3). Their survival rate, Oxford hip scores and activity levels are reviewed. Six patients died due to unrelated causes. There was one revision (0.02%) out of 440 hips. The mean Oxford score of the surviving 439 hips is 13.5. None of the patients were told to change their activities at work or leisure; 31% of the men with unilateral resurfacings and 28% with bilateral resurfacings were involved in jobs that they considered heavy or moderately heavy; 92% of men with unilateral hip resurfacings and 87% of the whole group participate in leisure-time sporting activity. The extremely low rate of failure in spite of the resumption of high level occupational and leisure activities provides early evidence of the suitability of this procedure for young and active patients with arthritis.
对于患有骨关节炎的年轻患者，即便固定技术和关节面有所改进，传统髋关节置换术的效果仍不尽人意。现代金属对金属髋关节表面置换术作为一种针对该特定群体的侵入性较小的关节重建方法被引入。这是由作者之一（DJWM）实施的一系列446例髋关节表面置换手术（384名患者），采用了骨水泥固定的股骨组件和羟基磷灰石涂层的非骨水泥髋臼组件，最长随访时间为8.2年（平均3.3年）。对其生存率、牛津髋关节评分和活动水平进行了回顾。6名患者因无关原因死亡。440例髋关节中有1例翻修（0.02%）。存活的439例髋关节的平均牛津评分为13.5。没有患者被告知要改变工作或休闲活动；接受单侧表面置换的男性中，31%从事他们认为繁重或中等繁重的工作，接受双侧表面置换的男性中这一比例为28%；接受单侧髋关节表面置换的男性中，92%以及整个研究组中的87%参与休闲体育活动。尽管恢复了高水平的职业和休闲活动，但失败率极低，这为该手术适用于年轻且活跃的关节炎患者提供了早期证据。
