Archibeck Michael J, Cummins Tamara, Junick Daniel W, White Richard E
New Mexico Center for Joint Replacement Surgery, New Mexico Orthopaedics, Albuquerque, NM 87106, USA.
Clin Orthop Relat Res. 2009 Jan;467(1):188-93. doi: 10.1007/s11999-008-0479-x. Epub 2008 Sep 10.
The use of extended offset femoral components and acetabular liners helps restore preoperative offset during hip arthroplasty. We report a relatively high acetabular component aseptic loosening rate with the use of offset polyethylene liners. We reviewed 1919 primary and 346 revision total hip arthroplasties (THAs). A 7-mm offset acetabular liner was used in 120 of the primary and 100 of the revision THAs. The aseptic loosening rate in the primary THA group was 0.12% in the standard offset and 4.2% in the extended offset groups at a minimum of 2 years (mean, 3.6 years; range, 2-9 years) followup. The aseptic loosening rate in the revision group was 1.7% in the standard and 7% in the extended offset groups at a mean of 4 years (range, 2-9 years) followup. Although extended offset acetabular liners help restore hip offset, torsional force applied to the implant-bone interface may have a detrimental effect on fixation. We found a relatively high failure rate in our primary and revision acetabular components used with an offset liner.
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
在髋关节置换术中,使用加长偏心距股骨假体组件和髋臼内衬有助于恢复术前偏心距。我们报告了使用偏心距聚乙烯内衬时髋臼组件无菌性松动率相对较高的情况。我们回顾了1919例初次全髋关节置换术和346例翻修全髋关节置换术(THA)。120例初次THA和100例翻修THA使用了7毫米偏心距髋臼内衬。在至少2年(平均3.6年;范围2至9年)的随访中,初次THA组标准偏心距组的无菌性松动率为0.12%,加长偏心距组为4.2%。在平均4年(范围2至9年)的随访中,翻修组标准偏心距组的无菌性松动率为1.7%,加长偏心距组为7%。尽管加长偏心距髋臼内衬有助于恢复髋关节偏心距,但施加于植入物-骨界面的扭力可能对固定产生不利影响。我们发现使用偏心距内衬的初次和翻修髋臼组件的失败率相对较高。
III级,治疗性研究。有关证据水平的完整描述,请参见作者指南。