Bizot P, Hannouche D, Nizard R, Witvoet J, Sedel L
Department of Orthopaedic Surgery, Lariboisiere Hospital, University of Paris VII, France.
J Bone Joint Surg Br. 2004 Mar;86(2):190-4. doi: 10.1302/0301-620x.86b2.14026.
Between 1990 and 1992, we implanted 71 hybrid alumina-on-alumina hip arthroplasties in 62 consecutive patients under the age of 55 years, with a mean age of 46 years at surgery. There were 56 primary and 15 secondary procedures. The prostheses involved a cemented titanium alloy stem, a 32 mm alumina head, and a press-fit metal-backed socket with an alumina insert. Three patients (four hips) died from unrelated causes. Four hips had revision surgery for either deep infection, unexplained persistent pain, fracture of the alumina head, or aseptic loosening of the socket. The nine-year survival rate was 93.7% with revision for any cause as the end-point and 98.4% with revision for aseptic loosening as the end-point. The outcome in the surviving patients (50 patients, 57 hips) with a minimum five-year follow-up (mean eight years) was excellent in 47 hips (82.5%), very good in eight (14%), good in one and fair in one. A thin, partial, lucent line, mainly in zone III was present in 38% of the sockets and one socket had a complete lucency less than 1 mm thick. One stem had isolated femoral osteolysis. There was no detectable component migration nor acetabular osteolysis. This hybrid arthroplasty gave satisfactory medium-term results in active patients. The press-fit metal-backed socket appeared to have reliable fixation in alumina-on-alumina hip arthroplasty. The excellent results using cemented fixation of the stem may be related to the low production of wear debris.
1990年至1992年间，我们为62例连续的55岁以下患者植入了71例氧化铝对氧化铝混合髋关节置换术，手术时的平均年龄为46岁。其中有56例初次手术和15例二次手术。假体包括一个骨水泥固定的钛合金柄、一个32毫米的氧化铝股骨头以及一个压配式金属背衬髋臼杯和氧化铝内衬。3例患者（4髋）死于无关原因。4髋因深部感染、不明原因的持续疼痛、氧化铝股骨头骨折或髋臼杯无菌性松动而接受翻修手术。以任何原因进行翻修为终点的九年生存率为93.7%，以无菌性松动进行翻修为终点的九年生存率为98.4%。在至少随访五年（平均八年）的存活患者（50例患者，57髋）中，47髋（82.5%）的结果为优，8髋（14%）为良，1髋为中，1髋为差。38%的髋臼杯出现一条薄的、部分透亮线，主要位于III区，1个髋臼杯有一条厚度小于1毫米的完全透亮线。1个柄出现孤立性股骨骨溶解。未检测到假体移位或髋臼骨溶解。这种混合关节置换术在活跃患者中取得了令人满意的中期结果。在氧化铝对氧化铝髋关节置换术中，压配式金属背衬髋臼杯似乎具有可靠的固定。柄采用骨水泥固定取得的优异结果可能与磨损碎屑产生量低有关。
