Schmalzried Thomas P, Silva Mauricio, de la Rosa Mylene A, Choi Eui-Sung, Fowble Vincent A
Joint Replacement Institute at Orthopaedic Hospital, Los Angeles, CA 90007, USA.
Clin Orthop Relat Res. 2005 Dec;441:200-4. doi: 10.1097/01.blo.0000192354.76792.bb.
Short-term failures of total hip resurfacing have been related to specific characteristics of the proximal femur. A radiographic arthritic hip grading scale was used to assess four characteristics of the proximal femur: bone density, shape, biomechanics, and focal bone defects. Hips with no unfavorable characteristics were Grade A, hips with one unfavorable characteristic were Grade B, hips with two unfavorable characteristics were Grade C, hips with three unfavorable characteristics were Grade D, and hips with four unfavorable characteristics were Grade F. One hundred forty-seven consecutive hips were treated with metal-on-metal resurfacing by a single surgeon. There were no femoral neck fractures. Of the 91 hips eligible for a minimum 2 year followup, 90% were Grades A or B, 10% were Grade C, and none were Grades D or F. With a minimum 2-year followup, arthritic hip grading was associated with preoperative Harris hip score, occurrence of mild to moderate postoperative pain, preoperative and postoperative range of motion, preoperative and postoperative hip center of rotation, preoperative and postoperative horizontal femoral offset, preoperative and postoperative limb length discrepancy, and acetabular radiolucencies. Hips with a lesser degree of secondary arthritic changes have a higher arthritic hip grade and better outcomes with total hip resurfacing. Relatively strict selection criteria for resurfacing were associated with a low occurrence of short-term failures.
Prognostic study, Level II (retrospective study). See the Guidelines for Authors for a complete description of levels of evidence.
全髋关节表面置换术的短期失败与股骨近端的特定特征有关。使用一种影像学关节炎髋关节分级量表来评估股骨近端的四个特征：骨密度、形状、生物力学和局灶性骨缺损。无不良特征的髋关节为A级，有一个不良特征的髋关节为B级，有两个不良特征的髋关节为C级，有三个不良特征的髋关节为D级，有四个不良特征的髋关节为F级。一位外科医生对147例连续的髋关节进行了金属对金属表面置换术。未发生股骨颈骨折。在91例符合至少2年随访条件的髋关节中，90%为A级或B级，10%为C级，无D级或F级。在至少2年的随访中，关节炎髋关节分级与术前Harris髋关节评分、轻至中度术后疼痛的发生、术前和术后活动范围、术前和术后髋关节旋转中心、术前和术后股骨水平偏移、术前和术后肢体长度差异以及髋臼透光线有关。继发性关节炎改变程度较轻的髋关节关节炎髋关节分级较高，全髋关节表面置换术的效果较好。相对严格的表面置换选择标准与短期失败的低发生率相关。
预后研究，II级（回顾性研究）。有关证据水平的完整描述，请参见作者指南。
