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第二代多孔涂层非骨水泥型全髋关节置换术具有较高的生存率。

Second-generation porous-coated cementless total hip arthroplasties have high survival.

作者信息

Chen Christopher J, Xenos John S, McAuley James P, Young Anthony, Engh Charles A

机构信息

Pacific Bone and Joint Clinic, Berkeley, CA, USA.

出版信息

Clin Orthop Relat Res. 2006 Oct;451:121-7. doi: 10.1097/01.blo.0000224047.71377.5e.

Abstract

We retrospectively reviewed 157 consecutive total hip arthroplasties performed with Prodigy stems and Duraloc cups to see whether design modifications made to these components would improve their clinical performance as compared with first-generation porous-coated components. At an average of 6.7 years postoperatively, 145 hips were available for followup. The data suggested encouraging clinical and radiographic performances for these second-generation components. With only two hips (1.4%) in this population being revised, survivorship analysis was 99% 5 years postoperatively. Bone ingrowth was evident in 99% of the stems, and all cups were stable at last followup. Large osteolytic lesions were observed in three acetabula and seven femurs with all femoral lesions being confined to the proximal Gruen Zones 1 or 7. Polyethylene wear averaged 0.10 +/- 0.14 mm/year. Ninety-eight percent of patients reported satisfaction with the procedure, and 7% reported activity-limiting pain. Early followup of the Prodigy-Duraloc combination in primary cementless total hip arthroplasties showed the Prodigy stem had similarly good clinical results compared with its predecessor, the AML stem, and the Duraloc cup was superior to its first-generation predecessor, the anatomic medullary locking cup with Acetabular Cup System (ACS) liner.

摘要

我们回顾性分析了连续157例使用Prodigy股骨柄和Duraloc髋臼杯进行的全髋关节置换术,以观察这些组件的设计改进与第一代多孔涂层组件相比是否能改善其临床性能。术后平均6.7年时,145髋可供随访。数据表明这些第二代组件在临床和影像学表现方面令人鼓舞。该队列中仅2髋(1.4%)进行了翻修,术后5年的生存率分析为99%。99%的股骨柄有明显的骨长入,末次随访时所有髋臼杯均稳定。在3个髋臼和7个股骨中观察到较大的骨溶解病变,所有股骨病变均局限于近端Gruen 1区或7区。聚乙烯磨损平均为0.10±0.14mm/年。98%的患者对手术表示满意,7%的患者报告有活动受限性疼痛。初次非骨水泥型全髋关节置换术中Prodigy-Duraloc组合的早期随访显示,Prodigy股骨柄与其前身AML股骨柄相比临床结果相似,Duraloc髋臼杯优于其第一代前身带髋臼杯系统(ACS)内衬的解剖型髓内锁定杯。

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