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新型模块化钛髋臼组件的聚乙烯磨损与骨溶解:7至13年的结果

Polyethylene wear and osteolysis with a new modular titanium acetabular component: results at 7 to 13 years.

作者信息

Lachiewicz Paul F, Hubbard John B, Soileau Elizabeth S

机构信息

Department of Orthopaedic Surgery, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina 27599-7055, USA.

出版信息

J Arthroplasty. 2008 Oct;23(7):971-6. doi: 10.1016/j.arth.2007.08.013. Epub 2008 Mar 4.

Abstract

The first-generation and second-generation modular titanium fiber-metal acetabular components were notable for high rates of pelvic osteolysis and liner dislodgment. This is a prospective, consecutive study of 111 new modular titanium-fiber metal acetabular components with a novel polyethylene locking mechanism at a mean follow-up of 9.5 years (range, 7-13 years). The polyethylene was gamma-irradiated in air in 58 hips and gamma-irradiated in nitrogen in 54 hips. No acetabular component migrated, none were revised, and there was no liner dislodgment. Pelvic osteolysis was seen in only 2 hips. The mean linear wear rate was 0.085 mm/y (range, 0.001-0.3 mm/y). There was a significantly lower rate of wear with polyethylene liners sterilized by gamma-irradiation in nitrogen (P = .0001). The high rate of success and low rate of polyethylene wear and pelvic osteolysis at this length of follow-up may be related to the new design features of this modular acetabular component.

摘要

第一代和第二代模块化钛纤维金属髋臼组件因骨盆骨溶解和衬垫移位发生率高而备受关注。这是一项前瞻性、连续性研究,纳入了111个新型模块化钛纤维金属髋臼组件,其采用了新型聚乙烯锁定机制,平均随访时间为9.5年(范围为7至13年)。58例髋关节的聚乙烯在空气中进行了γ射线辐照,54例髋关节的聚乙烯在氮气中进行了γ射线辐照。没有髋臼组件发生移位,无一例进行翻修,也没有衬垫移位。仅在2例髋关节中发现骨盆骨溶解。平均线性磨损率为0.085毫米/年(范围为0.001至0.3毫米/年)。在氮气中通过γ射线辐照灭菌的聚乙烯衬垫磨损率显著更低(P = 0.0001)。在如此长的随访期内,该模块化髋臼组件的高成功率、低聚乙烯磨损率和骨盆骨溶解率可能与新的设计特点有关。

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