Iwakiri Kentaro, Iwaki Hiroyoshi, Minoda Yukihide, Ohashi Hirotsugu, Takaoka Kunio
Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Clin Orthop Relat Res. 2008 May;466(5):1186-92. doi: 10.1007/s11999-008-0168-9. Epub 2008 Feb 21.
Alumina-on-alumina bearings for THA have markedly improved in mechanical properties through advances in technology; however, alumina fracture is still a concern. We retrospectively reviewed 77 patients (82 hips) with cemented alumina-on-alumina THAs to identify factors relating to alumina failure. The mean age of the patients at surgery was 63 years. The prostheses had a cemented polyethylene-backed acetabular component with an alumina inlay and a 28-mm alumina head. Revision surgery was performed because of alumina inlay failure in four hips (three fractures and one dissociation; 5.6%), deep infection in two, and recurrent dislocation in one. The 8-year survival rate was 90.7% with revision for any reason and 94.4% with revision for alumina failure as the end point. There were no differences in age, body mass index, gender, mobility, function, abduction angle, or size of component among the four hips with alumina failure and the remaining 68 hips without it; however, radiolucent lines in the sockets were more apparent in four cases with alumina inlay failure. This alumina-on-alumina THA thus yielded unsatisfactory medium-term results because we observed a high rate of catastrophic alumina inlay failure.
通过技术进步，用于全髋关节置换术（THA）的氧化铝对氧化铝轴承的机械性能有了显著改善；然而，氧化铝骨折仍是一个令人担忧的问题。我们回顾性分析了77例（82髋）行骨水泥固定氧化铝对氧化铝全髋关节置换术的患者，以确定与氧化铝失效相关的因素。患者手术时的平均年龄为63岁。假体包括一个带聚乙烯衬背的骨水泥固定髋臼组件，带有氧化铝镶嵌物和一个28毫米的氧化铝股骨头。因氧化铝镶嵌物失效（4髋，3例骨折和1例分离；5.6%）、深部感染（2髋）和复发性脱位（1髋）而进行了翻修手术。以任何原因进行翻修时，8年生存率为90.7%；以氧化铝失效为终点进行翻修时，8年生存率为94.4%。在4例发生氧化铝失效的髋关节与其余68例未发生失效的髋关节之间，年龄、体重指数、性别、活动度、功能、外展角度或组件尺寸均无差异；然而，在4例氧化铝镶嵌物失效的病例中，髋臼的透亮线更为明显。因此，这种氧化铝对氧化铝全髋关节置换术的中期结果并不理想，因为我们观察到氧化铝镶嵌物灾难性失效的发生率很高。
