Nath Rajendra, Gupta Anil Kumar, Chakravarty Unmesh, Nath Rohit
Department of Orthopedic Surgery, GSVM Medical College, Kanpur-208 002, India.
Indian J Orthop. 2010 Jul;44(3):283-8. doi: 10.4103/0019-5413.65152.
Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty.
We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs) male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15), sero positive rheumatoid arthritis (n=5), seronegative spondylo-arthropathy (n=4), neglected femoral neck fractures (n=3), healed tubercular arthritis (n=2) and post traumatic osteoarthritis of hip (n=2). The prostheses used were cemented Charnley's total hip (n=12) and cemented modular prosthesis (n=19). The results were assessed according to Harris hip score and radiographs taken at yearly intervals.
The mean follow-up is 12.7 yrs (range 11-16 yrs) Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (+/-3.7 ml), mean transfusion rate was 1.2 units (+/-.3). The complications were hypotension (n=7), shortening >1.5 cm (n=9), superficial infection (n=2) and malposition of prosthesis (n=1).
The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared to western yard sticks.
初次骨水泥型全髋关节置换术是一种用于治疗髋关节非创伤性和创伤性疾病的手术方法。需要长期随访以评估植入物的使用寿命并确立该手术方法。关于全髋关节置换术长期结果的印亚文献较为稀少。我们对接受初次骨水泥型全髋关节置换术的患者进行了为期10年的随访。
我们对30例患者的31个髋关节实施了初次骨水泥型全髋关节置换术。我们对这些病例进行了至少10年的随访，平均随访期为12.7年。患者的平均年龄为60.7岁（范围37 - 82岁），男女比例为2:1。临床诊断包括：股骨头缺血性坏死（n = 15）、血清阳性类风湿关节炎（n = 5）、血清阴性脊柱关节病（n = 4）、陈旧性股骨颈骨折（n = 3）、愈合的结核性关节炎（n = 2）以及髋关节创伤后骨关节炎（n = 2）。使用的假体为骨水泥型Charnley全髋关节（n = 12）和骨水泥型模块化假体（n = 19）。根据Harris髋关节评分以及每年拍摄的X线片对结果进行评估。
平均随访时间为12.7年（范围11 - 16年）。所有接受手术患者的结果显示，在10年或更长时间的随访中，Harris髋关节评分从术前平均29.2显著提高到79.9。然而，根据Harris髋关节评分显示，与炎症组相比，非炎症组的长期改善更为持续。平均失血量为450ml（±3.7ml），平均输血率为1.2单位（±0.3）。并发症包括低血压（n = 7）、缩短>1.5cm（n = 9）、浅表感染（n = 2）以及假体位置不当（n = 1）。
印亚患者的需求与文献中所讨论的不同。他们的疼痛耐受性高于西方人群，且经济限制较大。因此，与西方标准相比，印亚患者中的翻修手术较少。
