Jameson S S, Langton D J, Nargol A V F
University Hospital of North Tees, Hardwick, Stockton-on-Tees, England.
J Bone Joint Surg Br. 2010 Jan;92(1):28-37. doi: 10.1302/0301-620X.92B1.22769.
We present the early clinical and radiological results of Articular Surface Replacement (ASR) resurfacings in 214 hips (192 patients) with a mean follow-up of 43 months (30 to 57). The mean age of the patients was 56 years (28 to 74) and 85 hips (40%) were in 78 women. The mean Harris hip score improved from 52 (11 to 81) to 95 (27 to 100) at two years and the mean University of California, Los Angeles activity score from 3.9 (1 to 10) to 7.4 (2 to 10) in the same period. Narrowing of the neck (to a maximum of 9%) was noted in 124 of 209 hips (60%). There were 12 revisions (5.6%) involving four (1.9%) early fractures of the femoral neck and two (0.9%) episodes of collapse of the femoral head secondary to avascular necrosis. Six patients (2.8%) had failure related to metal wear debris. The overall survival for our series was 93% (95% confidence interval 80 to 98) and 89% (95% confidence interval 82 to 96) for hips with acetabular components smaller than 56 mm in diameter. The ASR implant has a lower diametrical clearance and a subhemispherical acetabular component when compared with other more frequently implanted metal-on-metal hip resurfacings. These changes may contribute to the higher failure rate than in other series, compared with other designs. Given our poor results with the small components we are no longer implanting the smaller size.
我们展示了214例髋关节（192例患者）进行关节表面置换（ASR）后的早期临床和放射学结果，平均随访时间为43个月（30至57个月）。患者的平均年龄为56岁（28至74岁），78名女性中有85个髋关节（40%）。两年时，Harris髋关节平均评分从52分（11至81分）提高到95分（27至100分），同期加利福尼亚大学洛杉矶分校活动评分从3.9分（1至10分）提高到7.4分（2至10分）。209个髋关节中有124个（60%）出现颈部变窄（最大9%）。有12例翻修（5.6%），包括4例（1.9%）早期股骨颈骨折和2例（0.9%）继发于缺血性坏死的股骨头塌陷。6例患者（2.8%）因金属磨损碎屑导致失败。我们系列的总体生存率为93%（95%置信区间80至98），直径小于56 mm的髋臼组件的髋关节总体生存率为89%（95%置信区间82至96）。与其他更常用的金属对金属髋关节表面置换相比，ASR植入物的直径间隙较小，髋臼组件为半球形。与其他设计相比，这些变化可能导致失败率高于其他系列。鉴于我们使用小尺寸组件的结果不佳，我们不再植入较小尺寸的产品。
