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髋关节表面置换术后中期生存率和功能如何?

What is the midterm survivorship and function after hip resurfacing?

机构信息

The London Hip Unit, 30 Devonshire Street, London, W1G 6PU, UK.

出版信息

Clin Orthop Relat Res. 2010 Dec;468(12):3221-7. doi: 10.1007/s11999-010-1438-x.

Abstract

BACKGROUND

Hip resurfacing arthroplasty is a common procedure that improves functional scores and has a reported survivorship between 95% and 98% at 5 years. However, most studies are reported from the pioneering rather than independent centers or have relatively small patient numbers or less than five years followup. Various factors have been implicated in early failure.

QUESTIONS/PURPOSES: Our purposes were to determine: (1) the midterm survival of the BHR; (2) the function in patients treated with hip resurfacing; and (3) whether age, gender, BMI, or size of components related to failure.

METHODS

We reviewed the first 302 patients (329 hips) on whom we performed resurfacing arthroplasty. We assessed the survivorship, change in functional hip scores (HHS, OHS, WOMAC, UCLA), and analyzed potential risk factors (age, gender, BMI, component size) for failure. The mean age at the time of surgery was 56.0 years (range, 28.2-75.5 years). The minimum followup was 5 years (mean, 6.6 years; range, 5-9.2 years).

RESULTS

Kaplan-Meier analysis showed survival of 96.5% (95% CI, 94.7-98.4) at 9 years taking revision for any cause as the endpoint. All functional hip scores (HHS, OHS, WOMAC, UCLA) improved. Survivorship was higher in men compared with women. The component sizes and body mass index were smaller in the revised group compared with the nonrevised group.

CONCLUSIONS

Medium-term survivorship and functional scores of hip resurfacing are comparable to those from the pioneering center. Hip resurfacing remains a good alternative to THA, particularly in the younger male population with relatively large femoral head sizes.

摘要

背景

髋关节表面置换术是一种常见的手术,可改善功能评分,5 年的生存率报告在 95%至 98%之间。然而,大多数研究报告来自先驱中心,而不是独立中心,或者患者数量相对较少或随访时间少于 5 年。各种因素都与早期失败有关。

问题/目的:我们的目的是确定:(1)BHR 的中期生存率;(2)接受髋关节表面置换术治疗的患者的功能;(3)年龄、性别、BMI 或部件大小与失败是否相关。

方法

我们回顾了对 302 名患者(329 髋)进行表面置换术的患者。我们评估了生存率、髋关节功能评分(HHS、OHS、WOMAC、UCLA)的变化,并分析了潜在的失败风险因素(年龄、性别、BMI、部件大小)。手术时的平均年龄为 56.0 岁(范围为 28.2-75.5 岁)。最低随访时间为 5 年(平均 6.6 年;范围为 5-9.2 年)。

结果

Kaplan-Meier 分析显示,以任何原因翻修为终点,9 年的生存率为 96.5%(95%CI,94.7-98.4)。所有髋关节功能评分(HHS、OHS、WOMAC、UCLA)均有所改善。男性的生存率高于女性。与未翻修组相比,翻修组的部件尺寸和体重指数较小。

结论

髋关节表面置换的中期生存率和功能评分与先驱中心相当。髋关节表面置换仍然是 THA 的一个很好的替代选择,特别是在相对较大股骨头尺寸的年轻男性人群中。

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