Klein M, Scherger B, Bernd H, Ostermann P A
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Z Orthop Unfall. 2008 Mar-Apr;146(2):179-84. doi: 10.1055/s-2008-1038397.
The purpose of this study was to evaluate peri- and postoperative complications and the clinical/radiological results after hip resurfacing with the ASR prosthesis in patients with osteoarthritis.
A prospective cohort study was performed including all patients who received a hip resurfacing (ASR prosthesis, DePuy, Motech, Warsaw, IN, USA) because of osteoarthritis between 1/2005 and 7/2006. 115 prostheses were performed in 110 patients (58 female, 52 male). In all patients a dorsal approach was used. The mean age was 57.82 years (range: 34 to 72 years) and the mean follow-up was after 12.5 months (range: 6 to 23 months). At the time of follow-up an X-ray (a. p. and axial) of the operated hip was performed in addition to the to standard clinical examination. To measure the functional outcome the Harris hip score was used.
We observed postoperative complications in 18 patients. Three non-trauma-related femoral neck fractures were seen after a mean of 58 days (range: 41 to 70 days). One trauma-related femoral neck fracture was found after 7 months. Neural complications were found in two patients. In 8 patients a revision of the acetabular component was necessary. 3 dislocations could be managed without further revision. One revision was necessary because of a persisting seroma without infection. No infections or thromboembolic complications were seen. The mean Harris hip score developed from preoperative 59 points (range: 50 to 65 points) to postoperative 96 points (range: 85 to 100 points).
Excellent early postoperative results can be reached by hip resurfacing. Special attention is necessary performing the correct positioning of the femoral and acetabular components. If notching is seen intraoperatively the operation should be switched and a large head prothesis should be implanted. Long-term results are still lacking.
本研究旨在评估骨关节炎患者使用ASR假体进行髋关节表面置换术后及围手术期并发症以及临床/放射学结果。
进行一项前瞻性队列研究，纳入2005年1月至2006年7月间因骨关节炎接受髋关节表面置换术（ASR假体，美国印第安纳州华沙市迪普伊公司莫泰克分部）的所有患者。110例患者（58例女性，52例男性）植入了115个假体。所有患者均采用后路入路。平均年龄为57.82岁（范围：34至72岁），平均随访时间为12.5个月（范围：6至23个月）。随访时，除了进行标准临床检查外，还对手术髋关节进行了X线（前后位和轴位）检查。采用Harris髋关节评分来衡量功能结果。
我们观察到18例患者出现术后并发症。平均58天（范围：41至70天）后出现3例与创伤无关的股骨颈骨折。7个月后发现1例与创伤有关的股骨颈骨折。2例患者出现神经并发症。8例患者需要对髋臼部件进行翻修。3例脱位无需进一步翻修即可处理。1例因持续存在血清肿且无感染而需要翻修。未观察到感染或血栓栓塞并发症。Harris髋关节评分平均从术前的59分（范围：50至65分）提高到术后的96分（范围：85至100分）。
髋关节表面置换术可取得优异的早期术后效果。在进行股骨和髋臼部件的正确定位时需要特别注意。如果术中发现有切迹，应更换手术方式并植入大头假体。长期结果仍有待观察。
