Diwanji Sanket R, Kim Sung Kyu, Seon Jong Keun, Park Sang Jin, Yoon Taek Rim
Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Korea.
J Arthroplasty. 2008 Oct;23(7):1009-15. doi: 10.1016/j.arth.2007.09.006. Epub 2008 Mar 4.
Total hip arthroplasty (THA) has been the most common surgery performed for complications of bipolar arthroplasty. We wanted to evaluate functional results and complications after conversion of bipolar hemiarthroplasty to THA in 25 patients followed for an average of 7.2 years. Indications for conversion included acetabular erosion with well-fixed femoral stem in 13 patients, acetabular erosion with femoral loosening in 8 patients, and periprosthetic fracture in 4 patients. The average Harris Hip Score improved from 41 (34 to 67) before conversion to 85 (65 to 95) at final follow-up. The average Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) score improved from 81 (41 to 96) before conversion to 17 (8 to 36) at final follow-up. Pain component of WOMAC improved from an average of 15 (7 to 20) to 4 (0 to 11). The stiffness component of WOMAC improved from 6 (2-8) to 30 (0-4) and the function component improved from 59 (36-68) to 17 (8-36). The complications included 2 recurrent dislocations, 2 dislocations, 1 acetabular loosening, and 1 trochanteric nonunion. One patient required revision of acetabular component. The conversion THA after symptomatic bipolar arthroplasty can offer reliable pain relief and functional improvement. The perioperative complications approximate those of revision THAs.
全髋关节置换术(THA)一直是针对双极人工关节置换术并发症所施行的最常见手术。我们想要评估25例患者在平均随访7.2年期间,双极半髋关节置换术转换为THA后的功能结果及并发症。转换的指征包括:13例髋臼侵蚀且股骨柄固定良好,8例髋臼侵蚀且股骨松动,4例假体周围骨折。平均Harris髋关节评分从转换前的41分(34至67分)提高到最终随访时的85分(65至95分)。平均西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分从转换前的81分(41至96分)提高到最终随访时的17分(8至36分)。WOMAC的疼痛部分从平均15分(7至20分)改善到4分(0至11分)。WOMAC的僵硬部分从6分(2至8分)改善到3分(0至4分),功能部分从59分(36至68分)改善到17分(8至36分)。并发症包括2例复发性脱位、2例脱位、1例髋臼松动和1例转子骨不连。1例患者需要翻修髋臼组件。有症状的双极人工关节置换术后转换为THA可提供可靠的疼痛缓解和功能改善。围手术期并发症与翻修THA的并发症相近。