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与Charnley股骨柄几何形状相似的粗糙表面股骨柄的十年生存率。

Ten-year survivorship of rough-surfaced femoral stem with geometry similar to Charnley femoral stem.

作者信息

Datir S P, Kurta I C, Wynn-Jones C H

机构信息

Department of Orthopaedic and Trauma, North Staffordshire Hospital Trust, Stoke-on-Trent, United Kingdom.

出版信息

J Arthroplasty. 2006 Apr;21(3):392-7. doi: 10.1016/j.arth.2004.11.018.

Abstract

The aim of this study is to review the 10-year results of 269 cemented total hip arthroplasties performed using the Harvard femoral stem with matte surface finish and Charnley stem-like geometry. This is a retrospective cross-sectional survivorship study. We retrospectively reviewed the results of 269 cemented total hip arthroplasties performed using the Harvard femoral stem in 257 patients (men/women 93:164, mean age 71.2 years) between 1990 and 1994. The median duration of follow-up for the surviving implants was 118 (range 60-129) months. Radiographs were reviewed to evaluate the type of osteoarthritis, cement mantle thickness, alignment of the components, presence of aseptic loosening, and radiolucent lines. Kaplan-Meier survival analysis and Cox proportional hazards analysis were performed to evaluate 10-year survival and the impact of various radiological parameters on the prosthesis survival respectively. Of the 248 eligible patients (260 hips), 6 patients (7 hips) were lost to follow-up, and 67 patients had died at the time of the study; 36 hips (35 patients) underwent revision surgery for aseptic failure (median duration 60 months, range 12-125 months), and 11 hips were revised for septic failure (median duration 24 months, range 10-53 months from the index procedure). The femoral component was revised in all patients, whereas the acetabular component was revised in 27 patients. Ten-year survival for the femoral and acetabular components using aseptic loosening (with and without revision surgery) as an end point was 77.5% (71.5%-83.5%) and 91.1% (87.2%-95%), respectively. Cox regression analysis did not reveal a statistically significant (P > 0.05) effect of various radiological parameters on survival rate. Our results demonstrate that the matte surface finish femoral component (with geometry similar to Charnley femoral component) has less satisfactory long-term survival rate.

摘要

本研究旨在回顾采用表面磨砂处理且具有查恩利型股骨柄几何形状的哈佛股骨柄进行的269例骨水泥型全髋关节置换术的10年结果。这是一项回顾性横断面生存研究。我们回顾了1990年至1994年间在257例患者(男性/女性为93:164,平均年龄71.2岁)中采用哈佛股骨柄进行的269例骨水泥型全髋关节置换术的结果。存活植入物的中位随访时间为118(范围60 - 129)个月。对X线片进行评估,以评价骨关节炎类型、骨水泥壳厚度、假体组件对线情况、无菌性松动的存在以及透亮线。分别进行Kaplan - Meier生存分析和Cox比例风险分析,以评估10年生存率以及各种放射学参数对假体生存的影响。在248例符合条件的患者(260髋)中,6例患者(7髋)失访,67例患者在研究时已死亡;36髋(35例患者)因无菌性失败接受翻修手术(中位时间60个月,范围12 - 125个月),11髋因感染性失败接受翻修手术(从初次手术起中位时间24个月,范围10 - 53个月)。所有患者均对股骨组件进行了翻修,而27例患者对髋臼组件进行了翻修。以无菌性松动(无论是否进行翻修手术)为终点,股骨和髋臼组件的10年生存率分别为77.5%(71.5% - 83.5%)和91.1%(87.2% - 95%)。Cox回归分析未显示各种放射学参数对生存率有统计学显著影响(P > 0.05)。我们的结果表明,表面磨砂处理的股骨组件(其几何形状类似于查恩利股骨组件)长期生存率不太令人满意。

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