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[杜罗姆™髋关节表面置换术。短期至中期临床及影像学结果]

[Durom™ hip resurfacing. Short- to midterm clinical and radiological outcome].

作者信息

Goronzy J, Stiehler M, Kirschner S, Günther K-P

机构信息

Klinik und Poliklinik für Orthopädie, Universitätsklinikum Carl Gustav Carus Dresden, 01307, Dresden.

出版信息

Orthopade. 2010 Sep;39(9):842-52. doi: 10.1007/s00132-010-1656-7.

DOI:10.1007/s00132-010-1656-7
PMID:20737133
Abstract

BACKGROUND

Modern hip resurfacing as an alternative for stemmed total hip replacement therapy is associated with a specific risk profile. The aim of this study was therefore to assess the short- to midterm clinical and radiological outcome after introduction of the Durom™ Hip Resurfacing prosthesis in a consecutive series.

MATERIALS AND METHODS

A total of 132 hips (119 patients, 34 female, mean age 48±8,3 years) were evaluated functionally (Harris Hip Score, UCLA and Tegner activity scores) and radiologically with a mean follow-up period of 29 (6-60) months. Furthermore, preoperative ASA- and Charnley-scores, perioperative parameters as well as complications were registered.

RESULTS

During the observation period the Harris Hip Score improved by a mean of 36.6 points to 92.5±11.6 points (p<0.01). ULCA and Tegner scores improved by a mean of 3.1 and 1.6 to 7.1 and 4.0 points, respectively. Three patients (2.3%) needed revision surgery due to periprosthetic fracture, prosthesis infection, and aseptic loosening of the femoral component. In four patients (3.1%) an initial migration of the acetabular component not requiring surgical revision was observed radiologically.

CONCLUSION

The Durom™ Hip Resurfacing prosthesis demonstrated a low revision rate and a good mid-term functional and radiological outcome. Due to acetabular cup migrations in a small number of patients we now use an implant with modified surface design.

摘要

背景

现代髋关节表面置换作为带柄全髋关节置换治疗的一种替代方法,具有特定的风险特征。因此,本研究的目的是评估连续系列患者引入Durom™髋关节表面置换假体后的短期至中期临床和放射学结果。

材料与方法

共评估了132例髋关节(119例患者,34例女性,平均年龄48±8.3岁),采用功能评估(Harris髋关节评分、UCLA和Tegner活动评分)以及放射学评估,平均随访期为29(6 - 60)个月。此外,记录术前ASA评分和Charnley评分、围手术期参数以及并发症。

结果

在观察期内,Harris髋关节评分平均提高了36.6分,达到92.5±11.6分(p<0.01)。ULCA和Tegner评分分别平均提高了3.1分和1.6分,达到7.1分和4.0分。3例患者(2.3%)因假体周围骨折、假体感染和股骨部件无菌性松动需要翻修手术。4例患者(3.1%)在放射学上观察到髋臼部件有初始移位,但无需手术翻修。

结论

Durom™髋关节表面置换假体显示出较低的翻修率以及良好的中期功能和放射学结果。由于少数患者出现髋臼杯移位,我们现在使用一种表面设计改良的植入物。

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本文引用的文献

1
Development of metal/metal hip resurfacing.金属对金属髋关节表面置换术的发展
Hip Int. 2003 Mar 15;13(1):41-53. doi: 10.1177/112070000301302s09.
2
Blood metal ion concentrations after hip resurfacing arthroplasty: a comparative study of articular surface replacement and Birmingham Hip Resurfacing arthroplasties.髋关节表面置换术后血液金属离子浓度:关节表面置换与伯明翰髋关节表面置换术的比较研究
J Bone Joint Surg Br. 2009 Oct;91(10):1287-95. doi: 10.1302/0301-620X.91B10.22308.
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The learning curve for adopting hip resurfacing among hip specialists.
髋关节专家采用髋关节表面置换术的学习曲线。
Clin Orthop Relat Res. 2010 Feb;468(2):382-91. doi: 10.1007/s11999-009-1106-1.
4
Hip resurfacing: patient and treatment options.髋关节表面置换:患者及治疗选择。
J Bone Joint Surg Am. 2009 Aug;91 Suppl 5:2-4. doi: 10.2106/JBJS.I.00341.
5
Early return to function after hip resurfacing: is it better than contemporary total hip arthroplasty?髋关节表面置换术后早期功能恢复:是否优于当代全髋关节置换术?
J Arthroplasty. 2010 Aug;25(5):748-53. doi: 10.1016/j.arth.2009.05.034. Epub 2009 Jul 29.
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Quantifying degree of difficulty in hip - resurfacing of pistol-grip deformity.量化手枪柄畸形髋关节表面置换的难度程度。
Bull NYU Hosp Jt Dis. 2009;67(2):154-8.
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Cementless femoral components in young patients: review and meta-analysis of total hip arthroplasty and hip resurfacing.年轻患者的非骨水泥股骨部件:全髋关节置换术和髋关节表面置换术的综述和荟萃分析。
J Arthroplasty. 2009 Sep;24(6 Suppl):2-8. doi: 10.1016/j.arth.2009.04.032. Epub 2009 Jun 24.
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High cup angle and microseparation increase the wear of hip surface replacements.高杯角和微分离会增加髋关节表面置换物的磨损。
Clin Orthop Relat Res. 2009 Sep;467(9):2259-65. doi: 10.1007/s11999-009-0830-x. Epub 2009 Apr 11.
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The development of the DuromTM metal-on-metal hip resurfacing.
Hip Int. 2006;16 Suppl 4:65-72. doi: 10.1177/112070000601604S13.
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Less range of motion with resurfacing arthroplasty than with total hip arthroplasty: in vitro examination of 8 designs.表面置换关节成形术的活动范围小于全髋关节置换术:8种设计的体外研究
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