Blacha Jan
Orthopedic Department, University Hospital nr 4, Medical Academy of Lublin, 20-950 Lublin, Poland.
Acta Orthop Scand. 2004 Jun;75(3):276-82. doi: 10.1080/00016470410001204.
There are few reports on the outcome of uncemented HA-coated cups in young patients.
I evaluated the 7-year (5-9) results of HA-coated hip prosthesis (ABG, Stryker) in a consecutive series of 65 primary arthroplasties on 56 patients (mean age 44 years). 2 patients were lost to follow-up and 3 died.
The cumulative survival rate with revision for any reason as endpoint at 9 years was 98% (95% CI, 96-100) for the stem, 69% (61-77) for the acetabular metal backing, and 59% (50-67) for the polyethylene liner. 15 of 65 cups were revised on average 6 years after the primary operation and 3 more are planned. Revisions were done in 3 hips because of loosening and migration of the cup, and in 12 hips because of wear and progressive osteolysis around stable components. Only hips with migration had clinical symptoms. Visual inspection of polyethylene liners revealed wear of the articulation in all cases, loosening of the locking mechanism in 10 cases and nonarticular surface deformity in 7 hips. All original stems are in situ although femoral osteolysis was seen in 12 cases and 1 hip was reoperated because of periprosthetic traumatic fracture. Despite the high revision rate, the clinical improvement was good: the average pre- and postoperative Harris Hip Scores at the most recent follow-up were 41 and 90, respectively.
While the results on the femoral side were good, the survival rates of the acetabular cups were poor and we stopped using ABG I hip prostheses.
关于非骨水泥型羟基磷灰石涂层髋臼杯在年轻患者中的使用结果，相关报道较少。
我评估了56例患者（平均年龄44岁）连续65例初次髋关节置换术中使用的羟基磷灰石涂层髋关节假体（ABG，史赛克公司）的7年（5 - 9年）随访结果。2例患者失访，3例患者死亡。
以任何原因翻修为终点，9年时股骨柄的累积生存率为98%（95%置信区间，96 - 100），髋臼金属衬背为69%（61 - 77），聚乙烯内衬为59%（50 - 67）。65个髋臼杯中有15个在初次手术后平均6年进行了翻修，另有3个计划翻修。3例髋关节因髋臼杯松动和移位进行翻修，12例髋关节因稳定部件周围磨损和进行性骨溶解进行翻修。只有发生移位的髋关节有临床症状。聚乙烯内衬的目视检查显示，所有病例均存在关节磨损，10例锁定机制松动，7例髋关节非关节面变形。所有初始股骨柄均在位，尽管12例出现股骨骨溶解，1例因假体周围创伤性骨折再次手术。尽管翻修率较高，但临床改善良好：最近一次随访时术前和术后Harris髋关节评分的平均值分别为41分和90分。
虽然股骨侧的结果良好，但髋臼杯的生存率较差，我们已停止使用ABG I型髋关节假体。
