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翻修多孔涂层模块化柄的全髋关节置换术:5 至 10 年随访。

Revision total hip arthroplasty with a porous-coated modular stem: 5 to 10 years follow-up.

机构信息

Orthopedic Department, Division of Arthroplasty, Mount Sinai Hospital, 600 University Avenue, Suite 476A, Toronto, Ontario M5G 1X5, Canada.

出版信息

Clin Orthop Relat Res. 2010 May;468(5):1310-5. doi: 10.1007/s11999-009-0937-0. Epub 2009 Jun 16.

Abstract

UNLABELLED

The ZMR porous stem is a modular cylindrical porous-coated femoral stem for revision THA. The objective of this study was to evaluate the clinical and radiographic outcomes of this stem at midterm followup. We prospectively reviewed 69 patients (72 femoral revisions) treated with the stem. The indication for revision was aseptic loosening in 61 (85%), periprosthetic fractures in five (7%), infection in three (4%), dislocation in two (3%), and fractured stem in one (1%). Minimum followup was 60 months (mean, 85 months; range, 60-114 months). The survival rate with revision for any reason as an end point was 93.8%. Mean preoperative Harris hip score was 39 points, and mean Harris hip score at last followup was 72 points. Four (5.5%) stems required rerevision, two (2.8%) for loosening, one (1.4%) for fracture at the modular junction, and one (1.4%) for infection. Subsidence occurred in eight (11%) patients, in the range of 5 to 25 mm. Two (2.89%) of the stems that subsided were symptomatic and progressive. The ZMR porous stem is a versatile system that offers a reliable fixation and an off-the-shelf solution for a multitude of femoral reconstruction challenges.

LEVEL OF EVIDENCE

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

摘要

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ZMR 多孔柄是一种用于翻修 THA 的模块化圆柱形多孔涂层股骨柄。本研究的目的是在中期随访时评估该柄的临床和影像学结果。我们前瞻性地回顾了 69 例(72 例股骨翻修)接受该柄治疗的患者。翻修的指征为无菌性松动 61 例(85%)、假体周围骨折 5 例(7%)、感染 3 例(4%)、脱位 2 例(3%)和柄断裂 1 例(1%)。最短随访时间为 60 个月(平均 85 个月;范围 60-114 个月)。以任何原因翻修为终点的生存率为 93.8%。术前平均 Harris 髋关节评分为 39 分,末次随访时平均 Harris 髋关节评分为 72 分。有 4 例(5.5%)需要再次翻修,其中 2 例(2.8%)因松动,1 例(1.4%)因在连接部发生骨折,1 例(1.4%)因感染。有 8 例(11%)患者发生下沉,范围为 5-25mm。有 2 例(2.89%)下沉的柄出现症状且逐渐加重。ZMR 多孔柄是一种多功能系统,可为多种股骨重建挑战提供可靠的固定和现成的解决方案。

证据水平

IV 级,治疗研究。有关证据水平的完整描述,请参见作者指南。

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