Utting M R, Raghuvanshi M, Amirfeyz R, Blom A W, Learmonth I D, Bannister G C
Royal Perth Rehabilitation Hospital, 6 Selby Street, Shenton Park, Western Australia 6008, Australia.
J Bone Joint Surg Br. 2008 Nov;90(11):1422-7. doi: 10.1302/0301-620X.90B11.20892.
We have reviewed 70 Harris-Galante uncemented acetabular components implanted as hybrid hip replacements with cemented stems between 1991 and 1995 in 53 patients whose mean age was 40 years (19 to 49). The mean follow-up was for 13.6 years (12 to 16) with no loss to follow-up. We assessed the patients both clinically and radiologically. The mean Oxford hip score was 20 (12 to 46) and the mean Harris hip score 81 (37 to 100) at the final review. Radiologically, 27 hips (39%) had femoral osteolysis, 13 (19%) acetabular osteolysis, and 31 (44%) radiolucent lines around the acetabular component. Kaplan-Meier survival curves were constructed for the outcomes of revision of the acetabular component, revision of the component and polyethylene liner, and impending revision for progressive osteolysis. The cumulative survival for revision of the acetabular component was 94% (95% confidence interval 88.4 to 99.7), for the component and liner 84% (95% confidence interval 74.5 to 93.5) and for impending revision 55.3% (95% confidence interval 40.6 to 70) at 16 years. Uncemented acetabular components with polyethylene liners undergo silent lysis and merit regular long-term radiological review.
我们回顾了1991年至1995年间在53例平均年龄为40岁（19至49岁）的患者中植入的70个Harris-Galante非骨水泥髋臼组件，这些组件作为混合髋关节置换术的一部分，采用骨水泥股骨柄。平均随访时间为13.6年（12至16年），无失访情况。我们对患者进行了临床和放射学评估。末次评估时，平均牛津髋关节评分为20（12至46），平均Harris髋关节评分为81（37至100）。放射学检查发现，27例髋关节（39%）出现股骨骨溶解，13例（19%）出现髋臼骨溶解，31例（44%）髋臼组件周围出现透亮线。绘制了Kaplan-Meier生存曲线，以评估髋臼组件翻修、组件和聚乙烯内衬翻修以及因进行性骨溶解而即将翻修的结果。髋臼组件翻修的累积生存率在16年时为94%（95%置信区间88.4至99.7），组件和内衬翻修为84%（95%置信区间74.5至93.5），即将翻修为55.3%（95%置信区间40.6至70）。带有聚乙烯内衬的非骨水泥髋臼组件会发生无症状溶解，值得定期进行长期放射学复查。
