Park Youn-Soo, Park Se-Jun, Lim Seung-Jae
Department of Orthopedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea.
Orthopedics. 2010 Nov 2;33(11):796. doi: 10.3928/01477447-20100924-11.
We analyzed the long-term results of a single-surgeon series of 102 cementless total hip arthroplasties (THAs) performed using a sandwich-type alumina ceramic bearing. The prostheses involved a porous-coated acetabular socket, a polyethylene-alumina composite liner, a 28-mm alumina head, and a grit-blasted titanium-alloy stem. Mean patient age at the time of THA was 39 years (range, 18-66 years), and 76% of the patients were younger than 50 years. All procedures were performed with use of the same surgical technique and the same implant at a single center. Mean follow-up was 115 months (range, 84-133 months). When failure was defined as revision of either the acetabular or the femoral component for any reason, Kaplan-Meier survival probability at 10 years was 95.3% (95% confidence interval, 89.5%-100%). Mean Harris Hip Score improved from 47 points (range, 16-70 points) preoperatively to 95 points (range, 85-100 points) at final follow-up. No radiographically detectable osteolysis around the acetabular or femoral component was observed in any hip. No patient reported squeaking in the operated hip. During the follow-up period, 3 hips (3%) required revision surgery; 2 underwent acetabular revision because of a ceramic liner fracture and 1 underwent revision for early loosening of the acetabular cup. Ten-year results of cementless THA with a sandwich-type alumina ceramic bearing were encouraging, and no great increase in ceramic failure rate was observed, which contrasts with the findings of previously reported short-term follow-up studies.
我们分析了由同一位外科医生采用三明治型氧化铝陶瓷轴承进行的102例非骨水泥型全髋关节置换术(THA)的长期结果。这些假体包括多孔涂层髋臼杯、聚乙烯 - 氧化铝复合衬垫、28毫米氧化铝股骨头以及喷砂处理的钛合金股骨柄。THA手术时患者的平均年龄为39岁(范围18 - 66岁),76%的患者年龄小于50岁。所有手术均在单一中心采用相同的手术技术和相同的植入物进行。平均随访时间为115个月(范围84 - 133个月)。当将因任何原因对髋臼或股骨部件进行翻修定义为失败时,10年时的Kaplan - Meier生存率为95.3%(95%置信区间,89.5% - 100%)。Harris髋关节评分平均从术前的47分(范围16 - 70分)提高到末次随访时的95分(范围85 - 1 hundred分)。在任何髋关节中均未观察到髋臼或股骨部件周围有影像学可检测到的骨溶解。没有患者报告手术侧髋关节有摩擦声。在随访期间,3例髋关节(3%)需要翻修手术;2例因陶瓷衬垫骨折进行髋臼翻修,1例因髋臼杯早期松动进行翻修。采用三明治型氧化铝陶瓷轴承的非骨水泥型THA的10年结果令人鼓舞,且未观察到陶瓷失败率大幅增加,这与先前报道的短期随访研究结果形成对比。