Reikerås Olav, Gunderson Ragnhild B
Orthopaedic Department, Rikshospitalet University Clinic, 0027 Oslo, Norway.
Arch Orthop Trauma Surg. 2006 Oct;126(8):503-8. doi: 10.1007/s00402-006-0176-8. Epub 2006 Jun 24.
There are many studies on the short and medium term results of hydroxyapatite (HA) coated acetabular components, but information on survival in the longer run is sparse. In this paper, we report 11 to 16 years follow up results of HA coated threaded versus HA coated hemispherical press fit cups.
During the years 1988-1993, we performed 323 primary total hip replacements in 276 patients with an HA coated acetabular component. In 128 cases we used a HA coated threaded cup, and in 195 cases a HA coated hemispherical press fit cup was inserted. There were 189 women and 87 men aged 15-79 (mean 48) years. During follow-up, 14 patients died and 21 patients would not come for the follow-up examination as they were doing quite well with their prostheses. These patients were censored at their last control examination. This left 241 patients (287 hips) followed for 11 to 16 (mean 13) years after the operation.
During the follow-up period 48 press fit cups and 9 threaded cups were revised, none because of infection. Survival analyses indicated a cumulative survival of the threaded HA coated cup of 0.91 (95% CI: 0.86-0.97) at 16 years with one patient at risk. The cumulative survival of the HA coated press fit cup was 0.74 (0.69-0.80) at 15 years with no patient at risk. The difference is significant (P = 0.0002). Wear and age was significantly associated with revision (P < 0.0001 and 0.0002, respectively), and wear was significantly (P < 0.0001) associated with osteolysis.
These results indicate that HA coated threaded cups provide satisfactory bony interlock to resist force loads in the long run whereas the HA coated hemispherical press fit cups do not.
关于羟基磷灰石（HA）涂层髋臼假体的短期和中期结果已有许多研究，但长期生存率的相关信息却很少。在本文中，我们报告了HA涂层螺纹杯与HA涂层半球形压配杯11至16年的随访结果。
1988年至1993年期间，我们对276例患者进行了323例初次全髋关节置换术，均使用了HA涂层髋臼假体。其中128例使用HA涂层螺纹杯，195例植入HA涂层半球形压配杯。患者年龄在15至79岁（平均48岁）之间，女性189例，男性87例。随访期间，14例患者死亡，21例患者因假体使用情况良好未前来接受随访检查。这些患者在最后一次对照检查时被截尾。最终，241例患者（287髋）在术后接受了11至16年（平均13年）的随访。
随访期间，48个压配杯和9个螺纹杯进行了翻修，均非因感染。生存分析表明，16年时HA涂层螺纹杯的累积生存率为0.91（95%可信区间：0.86 - 0.97），有1例患者仍处于风险中。15年时HA涂层压配杯的累积生存率为0.74（0.69 - .80），此时无患者处于风险中。差异具有统计学意义（P = 0.0002）。磨损和年龄与翻修显著相关（P分别< 0.0001和0.0002），且磨损与骨溶解显著相关（P < 0.0001）。
这些结果表明，HA涂层螺纹杯能提供令人满意的骨结合，长期抵抗力量负荷，而HA涂层半球形压配杯则不能。
