van Raay J J, Rozing P M
Department of Orthopaedic Surgery, University Hospital Leiden, The Netherlands.
J Arthroplasty. 1991 Mar;6(1):79-88. doi: 10.1016/s0883-5403(06)80160-9.
From 1979 to 1986, 42 uncemented surface arthroplasties were performed in 27 patients with an inflammatory arthropathy of the hip: median age at operation 40 years (range 19-65 ys), median follow-up period 73 months (range 36-120 mo). After 36 months, in 26 of 42 hips, the mean Harris Hip Score was excellent or good (mean 89, range 80-100). In 14 cases, the mean score was fair (76, range 70-79). Overall, those hips with the longest followup period (60-120 m) gradually improved over the years. No correlation was found between the clinical score and radiologic complications such as varus tilting of the femoral component, acetabular protrusion of the cup, or heterotopic ossification. Conversion to a conventional total hip arthroplasty was required in four patients. One patient required a total hip arthroplasty 86 months after the initial operation because of a femoral neck fracture. In two other patients, revision was performed after 60 and 32 months respectively because of a preexistent osteonecrosis and a severe foreign body response to polyethylene debris. Both patients had a varus tilting of the femoral component. In the fourth patient, in whom revision surgery was necessary 28 months after surface replacement there was no explanation for the varus shift of the femoral component. Regarding those problems that can appear after conventional total hip replacement in inflammatory arthropathy, we conclude that the uncemented surface replacement of the hip can be a reasonable alternative.
1979年至1986年期间，对27例患有髋部炎性关节病的患者实施了42例非骨水泥型表面置换术：手术时的中位年龄为40岁（范围19 - 65岁），中位随访期为73个月（范围36 - 120个月）。36个月后，42例髋关节中有26例的Harris髋关节平均评分优秀或良好（平均89分，范围80 - 100分）。14例的平均评分为中等（76分，范围70 - 79分）。总体而言，随访期最长（60 - 120个月）的那些髋关节多年来逐渐改善。未发现临床评分与诸如股骨部件内翻倾斜、髋臼杯突出或异位骨化等放射学并发症之间存在相关性。4例患者需要转换为传统全髋关节置换术。1例患者在初次手术后86个月因股骨颈骨折需要进行全髋关节置换术。另外2例患者分别在60个月和32个月后因先前存在的骨坏死以及对聚乙烯碎屑的严重异物反应而进行了翻修手术。这2例患者均有股骨部件内翻倾斜。第4例患者在表面置换术后28个月需要进行翻修手术，对于股骨部件内翻移位无法作出解释。关于炎性关节病患者在传统全髋关节置换术后可能出现的那些问题，我们得出结论，非骨水泥型髋关节表面置换术可以是一种合理的替代方案。
