Stiftung Orthopädische Universitätsklinik Heidelberg, Germany.
Int Orthop. 2010 Dec;34(8):1093-8. doi: 10.1007/s00264-009-0843-9. Epub 2009 Jul 24.
In the 1970s, high failure rates of cemented acetabular components, especially in young patients, in the middle- and long-term prompted a search for alternatives. The Mecring was one of the most popular first generation uncemented, threaded cups widely used in the 1980s for arthroplasty of the hip. First generation threaded cups commonly had smooth surface treatment and showed unacceptably high failure rates in the mid-term. In a consecutive series of 209 patients, 221 threaded uncemented acetabular cups with smooth surface treatment (Mecring) had been implanted in combination with one type of uncemented stem. Patients were followed up clinically and radiographically. The mean time of follow-up was 17 (range 15-20) years. In 91 (41%) hips the acetabular component had been revised or was awaiting revision: two hips for infection and 84 (38%) for aseptic loosening. Five hips were awaiting revision. The survival rate for all revisions including hips awaiting revision was 49% (95% CI: 41-57%) at 17 years. These results support the view that smooth, threaded acetabular components do not provide satisfactory long-term fixation and should be abandoned. Patients with these components must be closely monitored as the failure rate remains high in the long-term.
20 世纪 70 年代,骨水泥髋臼假体的高失败率,尤其是在中青年患者中,促使人们寻找替代方法。Mecring 是 20 世纪 80 年代广泛应用于髋关节置换的第一代非骨水泥、螺纹髋臼杯之一。第一代螺纹髋臼杯通常采用光滑表面处理,中期失败率高,无法接受。在连续的 209 例患者中,221 例采用光滑表面处理的非骨水泥螺纹髋臼杯(Mecring)与一种非骨水泥柄联合植入。对患者进行临床和影像学随访。平均随访时间为 17 年(范围 15-20 年)。91 例(41%)髋臼杯需要翻修或等待翻修:2 例因感染,84 例(38%)因无菌性松动。5 例等待翻修。17 年时,所有翻修(包括等待翻修的髋关节)的生存率为 49%(95%CI:41-57%)。这些结果支持这样的观点,即光滑的、螺纹髋臼杯并不能提供满意的长期固定,应予以摒弃。这些患者必须密切监测,因为长期失败率仍然很高。