Naal Florian D, Schmied Matthias, Munzinger Urs, Leunig Michael, Hersche Otmar
Department of Orthopaedic Surgery, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland.
Clin Orthop Relat Res. 2009 Jun;467(6):1516-21. doi: 10.1007/s11999-008-0456-4. Epub 2008 Aug 22.
Patients with osteoarthritis secondary to developmental dysplasia of the hip (DDH) typically are young and active, which might affect functional ratings or failure rates after resurfacing arthroplasty. We therefore evaluated 24 patients (32 hips; mean age, 44.2 years) after hip resurfacing performed for osteoarthritis secondary to DDH. We used the Harris hip score (HHS), the University of California, Los Angeles (UCLA) activity scale, and a sports and activity questionnaire. A radiographic analysis also was performed. We followed patients a minimum of 28 months (mean, 43 months; range 28-60 months). The HHS improved from a mean of 54.7 to 97.3 and UCLA activity levels increased from a mean of 5.3 to 8.6. All patients returned to sports activity at a mean of 11 weeks after surface replacement. There were no major differences in preoperative and postoperative participation in the most common sports and activities. Two of the 32 replacements (6%) failed. We detected femoral radiolucencies in 10 of the remaining 30 hips. Despite satisfactory outcomes in clinical scores, return to sports, and hip biomechanics, the failure rate of 6% was disappointing. Additional followup is important to assess if failure rates increase in these young, active patients.
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
继发于发育性髋关节发育不良（DDH）的骨关节炎患者通常年轻且活跃，这可能会影响表面置换关节成形术后的功能评分或失败率。因此，我们评估了24例（32髋；平均年龄44.2岁）因DDH继发骨关节炎而接受髋关节表面置换的患者。我们使用了Harris髋关节评分（HHS）、加利福尼亚大学洛杉矶分校（UCLA）活动量表以及一份运动和活动问卷。还进行了影像学分析。我们对患者进行了至少28个月的随访（平均43个月；范围28 - 60个月）。HHS评分从平均54.7提高到97.3，UCLA活动水平从平均5.3提高到8.6。所有患者在表面置换后平均11周恢复运动。术前和术后参与最常见运动和活动方面无重大差异。32例置换中有2例（6%）失败。我们在其余30髋中的10髋检测到股骨透亮线。尽管临床评分、恢复运动和髋关节生物力学方面结果令人满意，但6%的失败率令人失望。进一步随访对于评估这些年轻、活跃患者的失败率是否会增加很重要。
IV级，治疗性研究。有关证据水平的完整描述，请参阅作者指南。
