Lim Seung-Jae, Moon Young-Wan, Eun Sang-Soo, Park Youn-Soo
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
J Arthroplasty. 2008 Jun;23(4):495-501. doi: 10.1016/j.arth.2007.05.026. Epub 2007 Nov 7.
The aim of this study was to test the hypothesis that a previous joint-preserving procedure for osteonecrosis of the femoral head (ONFH) would compromise the outcome of a subsequent total hip arthroplasty. The clinical and radiographic results of total hip arthroplasty using the S-ROM stem (DePuy/Johnson & Johnson, Leeds, UK) in 36 hips with failed joint-preserving procedures for ONFH were compared with those in a matched control group of 39 osteonecrotic hips without a previous joint-preserving procedure. After a mean follow-up of 4.6 years, with the exception of 1 reoperation for polyethylene wear and osteolysis, no revisions due to mechanical failure of the prostheses had been performed in the study cohort of 36 hips. However, the study group had a longer operative time, more perioperative blood loss, a higher rate of intraoperative complications, and poorer postoperative ranges of hip motion than those in the control group. These results confirm the hypothesis that a previous joint-preserving procedure for ONFH poses technical challenges for a subsequent total hip reconstruction and might have a detrimental effect on the short-term clinical outcome.
先前针对股骨头缺血性坏死（ONFH）的保关节手术会影响随后全髋关节置换术的结果。将36例接受过针对ONFH的保关节手术但失败的髋关节采用S-ROM柄（英国利兹市DePuy/强生公司）进行全髋关节置换术的临床和影像学结果，与39例未接受过先前保关节手术的坏死性髋关节匹配对照组进行比较。平均随访4.6年后，除1例因聚乙烯磨损和骨溶解进行再次手术外，36例髋关节的研究队列中未因假体机械故障进行翻修手术。然而，研究组的手术时间更长、围手术期失血量更多、术中并发症发生率更高，且术后髋关节活动范围比对照组更差。这些结果证实了以下假设：先前针对ONFH的保关节手术给随后的全髋关节重建带来技术挑战，并且可能对短期临床结果产生不利影响。
