Braun A, Acker M
Vulpius Clinic, Vulpiusstrasse 29, Bad Rappenau, Germany.
Z Orthop Unfall. 2007 Sep-Oct;145 Suppl 1:S9-S12. doi: 10.1055/s-2007-965653.
In a retrospective study, all patients with bilateral cementless Bicontact-Plasmacup total hip arthroplasty in the period May 1993 to June 2000 were followed up clinically and radiologically.
Out of 537 hip replacements performed in this period with this combination of implants, 46 patients had bilateral surgery. At follow-up, the Harris Hip Score, the radiological changes between primary implantation and most recent follow-up and the radiologically visible wear of the polyethylene cup component were studied.
Thirty-seven patients were followed up. One patient had died and 8 patients could not be contacted. The average age at the first hip replacement was 57.8 years and it was 59.1 years at the second operation. The follow-up period was 6.5 years (min 4.8 and max 9.8 years). The average Harris Hip Score at the time of follow-up was 91 points. Up to the time of follow-up, no stem or cup implant had to be revised. There were no radiological signs of stem loosening. In the case of the cup components, increased linear wear values of more than 0.15 mm/year were found in 4 THAs that used a 28-mm ceramic-polyethylene bearing. In two of these cases, the cup was in a markedly steep position. One of these cup components was assessed as loosened.
The results of this study have confirmed the biomechanical concept of the implant system employed. In contrast to the stem design, the cup design and slide bearing options have been supplemented in the meantime. The ceramic bearing was only available from 1997 and was used less often in this group of patients than would be indicated today for patients of the same age and degree of activity.
在一项回顾性研究中,对1993年5月至2000年6月期间接受双侧非骨水泥型Bicontact-Plasmacup全髋关节置换术的所有患者进行了临床和影像学随访。
在此期间使用这种植入物组合进行的537例髋关节置换术中,46例患者接受了双侧手术。在随访时,研究了Harris髋关节评分、初次植入与最近一次随访之间的影像学变化以及聚乙烯髋臼杯组件的影像学可见磨损情况。
37例患者接受了随访。1例患者死亡,8例患者无法联系到。首次髋关节置换时的平均年龄为57.8岁,第二次手术时为59.1岁。随访期为6.5年(最短4.8年,最长9.8年)。随访时的平均Harris髋关节评分为91分。截至随访时,无需翻修任何股骨柄或髋臼杯植入物。没有股骨柄松动的影像学迹象。在髋臼杯组件方面,在4例使用28毫米陶瓷-聚乙烯轴承的全髋关节置换术中发现线性磨损值增加超过0.15毫米/年。其中2例髋臼杯处于明显陡峭的位置。其中1个髋臼杯组件被评估为松动。
本研究结果证实了所采用植入系统的生物力学概念。与股骨柄设计不同,髋臼杯设计和滑动轴承选项在此期间得到了补充。陶瓷轴承从1997年才开始使用,在这组患者中的使用频率低于如今对于相同年龄和活动程度患者的推荐使用频率。