热解碳人工关节置换治疗股骨头缺血性坏死和股骨骨折：一项初步研究。
Pyrolytic carbon endoprosthetic replacement for osteonecrosis and femoral fracture of the hip: a pilot study.
作者信息
Bernasek Thomas L, Stahl Jennifer L, Pupello Derek
机构信息
Adult Reconstruction Service, Florida Orthopaedic Institute, 13020 Telecom Parkway North, Tampa, FL 33637, USA.
出版信息
Clin Orthop Relat Res. 2009 Jul;467(7):1826-32. doi: 10.1007/s11999-009-0820-z. Epub 2009 Apr 11.
UNLABELLED
Hemiarthroplasty in young patients has the potential for eliminating bearing wear, but has the disadvantage of cartilage wear. Low-temperature isotropic (LTI) pyrolytic carbon reportedly reduces cartilage wear in canine hemiarthroplasties. We therefore initiated a study in humans when it was released for human use. However, we observed failures in some patients. We therefore document and report the high failure rate observed in a subset of patients treated with an LTI pyrolytic carbon femoral head for osteonecrosis. We conducted a prospective pilot study of 17 patients treated with a titanium stem and an LTI pyrolytic carbon femoral head bearing surface for unipolar hemiarthroplasty for either femoral neck fracture (10 patients) or osteonecrosis (seven patients). One of 10 patients in the fracture group underwent conversion to THA as a result of arthritic progression compared with six of seven patients with osteonecrosis who underwent conversion to THA as a result of acetabular wear and severe groin pain. In this small series, patients with osteonecrosis had a higher rate of revision compared with the patients treated for femoral neck fracture.
LEVEL OF EVIDENCE
Level III, therapeutic study.
未标注
年轻患者的半髋关节置换术有可能消除关节面磨损，但存在软骨磨损的缺点。据报道，低温各向同性（LTI）热解碳可减少犬类半髋关节置换术中的软骨磨损。因此，当它被批准用于人体时，我们启动了一项人体研究。然而，我们观察到一些患者出现了失败情况。因此，我们记录并报告了在一部分接受LTI热解碳股骨头治疗骨坏死的患者中观察到的高失败率。我们对17例患者进行了一项前瞻性初步研究，这些患者接受了钛柄和LTI热解碳股骨头关节面的单极半髋关节置换术，用于治疗股骨颈骨折（10例患者）或骨坏死（7例患者）。骨折组10例患者中有1例因关节炎进展而转为全髋关节置换术，而7例骨坏死患者中有6例因髋臼磨损和严重腹股沟疼痛而转为全髋关节置换术。在这个小系列研究中，与接受股骨颈骨折治疗的患者相比，骨坏死患者的翻修率更高。
证据水平
III级，治疗性研究。
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