Department of Orthopaedic Surgery, Schulthess Clinic, Lengghalde 2, 8008 Zurich, Switzerland.
Clin Orthop Relat Res. 2011 Sep;469(9):2598-604. doi: 10.1007/s11999-011-1792-3. Epub 2011 Jan 29.
BACKGROUND/RATIONALE: There is growing evidence that different resurfacing implants are associated with variable survival and revision rates. A registry analysis indicated the Durom resurfacing implant had high revision rates at 5 years, whereas three original studies reported low revision rates at short-term followups. Thus, the revision rates appear controversial.
QUESTIONS/PURPOSES: We therefore assessed (1) the survivorship including differences between women and men at a mean of 5 years after resurfacing with the Durom implant, and (2) clinical scores and radiographic parameters.
We prospectively followed all 100 Durom hip resurfacings implanted in 91 patients (25 women and 66 men; mean age, 52 years) between 2003 and 2004. Survivorship analysis was performed with pending revision or revision for any reason as the endpoint. The minimum followup was 47 months (mean, 60 months; range, 47-72 months).
At a mean of 5 years, 11 hips were revised for various reasons. Cumulative survival was 88.2% for all patients and 81.5% for women. The mean Oxford (OHS) and Harris hip (HHS) scores were 14.6 and 94.7, respectively. The mean UCLA activity level was 7.9. Sclerotic changes around the short femoral stem (pedestal sign) were detected in 40% of the hips. We observed considerable femoral neck thinning with component-to-neck ratios of 0.85 preoperatively and 0.82 at 5 years.
Our study highlights a high revision rate 5 years after hip resurfacing with the Durom implant. This observation underlines previous findings from registry data and suggests that revision rates increase with time.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
背景/理由：越来越多的证据表明，不同的表面置换植入物与不同的生存率和翻修率有关。一项注册分析表明，Durom 表面置换植入物在 5 年内的翻修率较高，而三项原始研究报告在短期随访中翻修率较低。因此，翻修率似乎存在争议。
问题/目的：因此，我们评估了（1）Durom 植入物表面置换后 5 年的生存率，包括男女之间的差异，以及（2）临床评分和影像学参数。
我们前瞻性地随访了 2003 年至 2004 年间植入的 100 例 Durom 髋关节表面置换患者（91 例患者，25 例女性，66 例男性；平均年龄 52 岁）。以等待翻修或任何原因的翻修为终点进行生存分析。最低随访时间为 47 个月（平均 60 个月；范围 47-72 个月）。
平均 5 年后，11 髋因各种原因接受了翻修。所有患者的累积生存率为 88.2%，女性为 81.5%。平均牛津（OHS）和哈里斯髋关节（HHS）评分分别为 14.6 和 94.7。平均 UCLA 活动水平为 7.9。在 40%的髋关节中发现了股骨短干周围的硬化改变（基座征）。我们观察到术前组件-颈部比值为 0.85，5 年后为 0.82，股骨颈明显变薄。
我们的研究强调了 Durom 髋关节表面置换术后 5 年的高翻修率。这一观察结果强调了来自注册数据的先前发现，并表明翻修率随时间增加而增加。
IV 级，治疗研究。欲了解完整的证据水平描述，请参见作者指南。
