Yue Eric J, Cabanela Miguel E, Duffy Gavan P, Heckman Michael G, O'Connor Mary I
Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Clin Orthop Relat Res. 2009 Apr;467(4):992-9. doi: 10.1007/s11999-008-0506-y. Epub 2008 Sep 24.
Many early metal-on-polyethylene hip resurfacing arthroplasty designs were abandoned after reports of high short-term and midterm failure rates. To investigate factors associated with failure, we retrospectively reviewed our experience with early-design hip resurfacing implants in 75 patients during a 25-year period (median followup, 7.9 years; range, 0.1-25.2 years). Implant failure was defined as revision for any reason. One of 75 patients was lost to followup. The estimated rate of implant survival was 73% at 5 years, 34% at 10 years, 27% at 15 years, 12% at 20 years, and 8% at 25 years. Of the many clinical and radiographic factors considered, only age, implant type, and gender were associated with implant survival independent of other variables considered. Hip resurfacing arthroplasty showed poor overall long-term survival in this series. Particular attention should be paid to the identified risk factors as long-term followup data become available for modern designs.
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
在有报道称早期金属对聚乙烯髋关节表面置换术设计的短期和中期失败率较高后，许多此类设计被放弃。为了研究与失败相关的因素，我们回顾性分析了25年间75例接受早期设计髋关节表面置换植入物患者的情况（中位随访时间7.9年；范围0.1 - 25.2年）。植入物失败定义为因任何原因进行翻修。75例患者中有1例失访。估计植入物5年生存率为73%，10年为34%，15年为27%，20年为12%，25年为8%。在考虑的众多临床和影像学因素中，只有年龄、植入物类型和性别与植入物生存率相关，且独立于其他考虑的变量。在本系列研究中，髋关节表面置换术总体长期生存率较差。随着现代设计长期随访数据的可得，应特别关注已确定的风险因素。
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。
