Macquarie University Hospital, Sydney Adventist Hospital, 116 Macquarie Street, Parramatta 2150 NSW, Australia.
J Bone Joint Surg Am. 2011 Jun 1;93(11):1039-44. doi: 10.2106/JBJS.I.01757.
We present the results of cementless total hip arthroplasty performed with use of an anatomically adapted femoral stem and hemispherical cup with a fully coated Spongiosa-I metal surface, which was designed to achieve a surface similar to human cancellous bone. The purpose of the present retrospective case series was to determine the long-term outcomes of this hip arthroplasty system after a minimum of twenty years of follow-up.
Between 1983 and 1985, 209 consecutive total hip arthroplasty procedures (199 patients) were performed with use of the first-generation Spongiosa metal-surface chromium-cobalt total hip implant with an articulating surface consisting of a ceramic head and an ultra-high-molecular-weight polyethylene liner. We report the clinical and radiographic outcomes, the rates of and reasons for revision, and the influence of sex and age on outcome and complications.
At the time of the latest follow-up, twenty-seven patients had died and thirteen patients had been lost to follow-up; none of these forty patients had had revision surgery. The outcomes for 159 patients (169 prostheses) were reviewed. The mean duration of follow-up was 262 months (range, 242 to 275 months). There were nineteen revisions, including fourteen revisions of the femoral stem, two revisions of the acetabular cup, and three revisions of both components. The mean Harris hip score for patients who did not undergo revision surgery was 82 points. The probability of survival of both components at twenty years, with revision for any reason as the end point, was 97%. The probability of survival of the acetabular component was 98%, and the probability of survival of the femoral component only was 86%. The probability of component survival was significantly increased among older patients.
The results of cementless hip arthroplasty with use of the first-generation Spongiosa implant were excellent at a minimum of twenty years of follow-up. The probability of survival of the acetabular component exceeded that of the femoral stem.
我们展示了使用解剖适应股骨柄和半球形杯与完全涂层的松质骨-I 金属表面进行非骨水泥全髋关节置换术的结果，该设计旨在实现类似于人类松质骨的表面。本回顾性病例系列的目的是确定这种髋关节置换系统在至少 20 年的随访后的长期结果。
在 1983 年至 1985 年间，使用第一代 Spongiosa 金属表面铬钴全髋关节植入物进行了 209 例连续全髋关节置换术（199 例患者），该植入物的关节表面由陶瓷头和超高分子量聚乙烯衬里组成。我们报告了临床和影像学结果、翻修率和原因，以及性别和年龄对结果和并发症的影响。
在最近一次随访时，27 例患者死亡，13 例患者失访；这 40 例患者均未接受翻修手术。对 159 例患者（169 个假体）的结果进行了回顾。平均随访时间为 262 个月（范围，242 至 275 个月）。共进行了 19 次翻修，包括 14 次股骨柄翻修、2 次髋臼杯翻修和 3 次两者组件翻修。未行翻修手术患者的平均 Harris 髋关节评分为 82 分。以任何原因进行翻修为终点时，两种组件在 20 年时的生存率为 97%。髋臼组件的生存率为 98%，仅股骨组件的生存率为 86%。组件生存率在老年患者中显著提高。
在至少 20 年的随访中，第一代 Spongiosa 植入物的非骨水泥髋关节置换术结果优异。髋臼部件的存活率超过股骨柄。
