Midlands Orthopaedics, pa, 1910 Blanding St, Columbia, SC 29201, USA.
Int Orthop. 2012 Jan;36(1):27-34. doi: 10.1007/s00264-011-1290-y. Epub 2011 Jun 7.
Smaller femoral component size has been implicated as underlying the risk factor that explains the higher failure rate in women who have a hip resurfacing arthroplasty (HRA). We suspect that the diagnosis of dysplasia may be a more important causative risk factor than either small component size or female gender.
From January 2002 to July 2008, a total of 1,216 HRA cases, 1,082 with the primary diagnosis of osteoarthritis and 134 with dysplasia, were included in this study. Of them, 867 cases were performed in men and 349 performed in women. The average femoral component size was 51 ± 4 mm. Cox proportional hazard regression models were used to evaluate the significance of each variable and determine the causative risk factors for failure.
The average follow-up was 5 ± 2 years. Thirty-nine cases failed (20 in men vs. 19 in women). The failure rate for the whole group was 3.2% (2.3% in men vs. 5.4% in women; P = 0.01). Dysplasia (P = 0.05) was identified as the only significant risk factor in our multi-variable analysis; small femoral component size (P = 0.09) and gender (P = 0.76) were not significant risk factors. Women with the primary diagnosis of dysplasia had a survivorship rate of only 75% compared to 93% for the entire group at eight-year follow-up post-operatively.
In our study, we found that the high incidence of dysplasia in young women undergoing HRA was the reason that women had a higher failure rate after HRA. In dysplasia, 70% of failures were due to acetabular problems, of which 50% were due to failure of fixation and 20% due to adverse wear.
较小的股骨部件尺寸被认为是导致女性髋关节表面置换术（HRA）失败率较高的潜在风险因素。我们怀疑，发育不良的诊断可能是比部件尺寸小或女性性别更为重要的致病危险因素。
从 2002 年 1 月至 2008 年 7 月，共纳入了 1216 例 HRA 病例，其中 1082 例原发性诊断为骨关节炎，134 例为发育不良。其中，867 例为男性，349 例为女性。平均股骨部件尺寸为 51±4mm。使用 Cox 比例风险回归模型评估每个变量的显著性，并确定失败的致病危险因素。
平均随访时间为 5±2 年。39 例失败（男性 20 例，女性 19 例）。总组的失败率为 3.2%（男性为 2.3%，女性为 5.4%；P=0.01）。多变量分析中，仅发现发育不良（P=0.05）是唯一的显著危险因素；股骨部件尺寸小（P=0.09）和性别（P=0.76）不是显著的危险因素。女性的主要诊断为发育不良，术后 8 年的随访中，其存活率仅为 75%，而整个组的存活率为 93%。
在我们的研究中，我们发现年轻女性接受 HRA 时发育不良的发生率较高，是导致女性 HRA 后失败率较高的原因。在发育不良中，70%的失败是由于髋臼问题，其中 50%是由于固定失败，20%是由于不良磨损。
