Delank Karl-Stefan, Drees Philipp, Menzel Nicole, Hansen Torsten, Duschner Heinz, Eckardt Anke
Department of Orthopaedic Surgery, University of Cologne, Joseph-Stelzmannstrasse 9, 50931 Koeln, Germany.
Arch Orthop Trauma Surg. 2006 Oct;126(8):509-16. doi: 10.1007/s00402-006-0168-8. Epub 2006 Jun 21.
The cementless, hydroxyapatite-coated Anatomique Benoist Giraud-I (ABG-I) hip endoprosthesis represented a modern implant in the 1990s. The aim of the current retrospective study was to evaluate the clinical and radiological results of this prosthesis. In addition, an analysis of the complications and retrieved implants was conducted.
MATERIALS/METHODS: The medium-term results (follow-up 5.23 years) of 193 hip joints are presented. Of 158 total cohorts, 81.9% was able to undergo follow-up performed with standardized clinical and radiological investigations. Physical characteristics of the patients and the underlying disease prompting the need for total hip arthroplasty, as well as a clinical score (Merle d'Aubigné) were recorded. At the time of follow-up, a radiologic examination of all patients with a standardized evaluation was performed. In addition, the migration of the acetabular cup and femoral head as well as polyethylene wear could be determined digitally in 118 cases (61.1%) using one-picture Roentgen analysis.
Clinical results, as measured with a Merle d'Aubigné Score increase from 8.4 to 16.2, were very good. Radiographs demonstrated successful osseous integration of the anatomically molded shaft. Within the period of the investigation, no revision procedures of the femoral shaft were necessary. However, the rate of polyethylene abrasion of 0.23 mm/year was markedly high. 13.9% of hips (n = 27) required acetabular cup revision due to wear. This calculates to a prosthesis 7-year survival probability of 63%. Intraoperative findings during the revision cases showed extensive periacetabular osteolysis with foreign body granulation tissue. Analysis of data from the total patient cohort versus data from cases requiring revision showed a significantly increased frequency of high polyethylene wear in young active patients as well as in cases where an unfavorable acetabular cup to femoral head relation existed in correspondence with polyethylene thickness. There is evidence, however, that suggests that multifactorial causes for the increased wear are significant in regards to the principal material and technical features of the prosthesis.
On the basis of these results, it is strongly recommended that all patients treated with an ABG-I hip endoprosthesis should receive close clinical and most importantly close radiologic follow-up.
无骨水泥、羟基磷灰石涂层的Anatomique Benoist Giraud-I（ABG-I）髋关节假体在20世纪90年代代表了一种现代植入物。本回顾性研究的目的是评估该假体的临床和放射学结果。此外，还对并发症和取出的植入物进行了分析。
材料/方法：介绍了193个髋关节的中期结果（随访5.23年）。在158个总队列中，81.9%的患者能够接受标准化临床和放射学检查的随访。记录了患者的身体特征、导致需要进行全髋关节置换术的基础疾病以及临床评分（Merle d'Aubigné评分）。在随访时，对所有患者进行了标准化评估的放射学检查。此外，在118例（61.1%）患者中，使用单张X线分析可以数字化确定髋臼杯和股骨头的移位以及聚乙烯磨损情况。
用Merle d'Aubigné评分衡量的临床结果从8.4提高到16.2，非常好。X线片显示解剖型模制柄成功实现骨整合。在研究期间，无需对股骨干进行翻修手术。然而，聚乙烯磨损率为每年0.23毫米，明显较高。13.9%的髋关节（n = 27）因磨损需要进行髋臼杯翻修。据此计算，假体7年生存率为63%。翻修病例的术中发现显示髋臼周围广泛骨溶解伴异物肉芽组织。对总患者队列数据与需要翻修病例的数据进行分析表明，年轻活跃患者以及髋臼杯与股骨头关系不利且与聚乙烯厚度相关的病例中，聚乙烯高磨损的频率显著增加。然而，有证据表明，就假体的主要材料和技术特征而言，磨损增加的多因素原因很重要。
基于这些结果，强烈建议所有接受ABG-I髋关节假体治疗 的患者应接受密切的临床随访，最重要的是密切的放射学随访。
