Australian Orthopaedic Association National Joint Replacement Registry, Australia.
Acta Orthop. 2010 Feb;81(1):72-6. doi: 10.3109/17453671003667176.
Recent years have seen a rapid increase in the use of resurfacing hip arthroplasty despite the lack of literature on the long-term outcome. In particular, there is little evidence regarding the outcome of revisions of primary resurfacing. The purpose of this analysis was to examine the survivorship of primary resurfacing hip arthroplasties that have been revised.
Over 12,000 primary resurfacing hip arthroplasties were recorded by the Australian Orthopaedic Association National Joint Replacement Registry between September 1, 1999 and December 31, 2008. During this time, 397 revisions for reasons other than infection were reported for these primary resurfacings and classified as acetabular, femoral, or both acetabular and femoral revisions. The survivorship of the different types of revisions was estimated using the Kaplan-Meier method and compared using proportional hazard models. Additionally, the outcome of a femoral-only revision was compared to that of primary conventional total hip arthroplasty.
Acetabular-only revision had a high risk of re-revision compared to femoral-only and both acetabular and femoral revision (5-year cumulative per cent revision of 20%, 7%, and 5% respectively). Femoral-only revision had a risk of re-revision similar to that of revision of both the acetabular and femoral components. Femoral-only revision had over twice the risk of revision of primary conventional total hip arthroplasty.
Revision of a primary resurfacing arthroplasty is associated with a major risk of re-revision. The best outcome is achieved when either the femoral-only or both the acetabular and femoral components are revised. Technically straightforward femoral-only revisions generally have a worse outcome than a primary conventional total hip arthroplasty.
尽管缺乏关于长期结果的文献，但近年来，表面置换髋关节成形术的应用迅速增加。特别是，关于原发性表面置换翻修的结果几乎没有证据。本分析的目的是检查已行翻修的原发性表面置换髋关节成形术的生存率。
1999 年 9 月 1 日至 2008 年 12 月 31 日，澳大利亚矫形协会全国关节置换登记处记录了超过 12000 例原发性表面置换髋关节成形术。在此期间，报告了 397 例原发性表面置换术以外的原因进行的翻修，分为髋臼、股骨或髋臼和股骨均进行翻修。使用 Kaplan-Meier 方法估计不同类型翻修的生存率，并使用比例风险模型进行比较。此外，还比较了股骨单侧重修与原发性常规全髋关节置换的结果。
与股骨单侧重修和髋臼及股骨均翻修相比，髋臼单侧重修的再翻修风险较高（5 年累积再翻修百分率分别为 20%、7%和 5%）。股骨单侧重修的再翻修风险与髋臼和股骨组件均翻修的风险相似。股骨单侧重修的再翻修风险是原发性常规全髋关节置换的两倍以上。
原发性表面置换关节成形术的翻修与再翻修的主要风险相关。当仅进行股骨或髋臼和股骨组件的翻修时，可获得最佳结果。技术上简单的股骨单侧重修通常比原发性常规全髋关节置换的结果更差。
