Department of Orthopaedic Surgery, Friedrich-Alexander-University of Erlangen-Nuremberg, Rathsberger Str. 57, 91054 Erlangen, Germany.
Int Orthop. 2011 Feb;35(2):195-200. doi: 10.1007/s00264-010-1150-1. Epub 2010 Nov 16.
Ceramic-on-ceramic coupling is thought to be a durable alternative to metal- or alumina-on-polyethylene pairing. No evidence exists suggesting superior clinical and radiological results for hydroxyapatite-coated stems versus uncoated stems. The aim of this study is to report the performance of an alumina-on-alumina bearing cementless total hip arthroplasty and to compare stems with a tapered design with and without hydroxyapatite coating. We prospectively analysed the results of cementless tapered femoral stems (40 hydroxyapatite-coated versus 22 uncoated stems), a metal-backed fibre mesh hydroxyapatite-coated socket and alumina-on-alumina pairing. Of 75 hips studied, 62 were available for follow-up (mean of 10.5 years after surgery). The average Harris hip score was 90. Only one hydroxyapatite-coated stem was revised for aseptic loosening. One instance of non-progressive osteolysis was detected around a screw of a cup. All other components showed radiographic signs of stable ingrowth. Hydroxyapatite coating of the stem had no significant impact on the clinical or radiological results. Total hip arthroplasty with the presented implant and pairing provides a durable standard for all patients requiring hip joint replacement against which all newer generations of cementless implants should be judged.
陶瓷对陶瓷的结合被认为是金属或氧化铝对聚乙烯结合的一种耐用替代品。没有证据表明羟基磷灰石涂层的柄相对于未涂层的柄具有更好的临床和影像学结果。本研究旨在报告氧化铝对氧化铝承窝无水泥全髋关节置换的性能，并比较具有和不具有羟基磷灰石涂层的锥形设计的柄。我们前瞻性地分析了无水泥锥形股骨柄（40 个羟基磷灰石涂层与 22 个未涂层柄）、金属背纤维网羟基磷灰石涂层窝和氧化铝对氧化铝配对的结果。在研究的 75 个髋关节中，有 62 个可进行随访（术后平均随访 10.5 年）。平均 Harris 髋关节评分为 90 分。只有一个羟基磷灰石涂层的柄因无菌性松动而被修改。一个杯的螺钉周围发现一例非进行性溶骨。所有其他组件均显示出稳定植入的影像学迹象。柄的羟基磷灰石涂层对临床或影像学结果没有显著影响。具有所介绍的植入物和配对的全髋关节置换术为所有需要髋关节置换的患者提供了一种耐用的标准，所有新一代无水泥植入物都应以此为标准进行评估。
