Hirose Shiro, Otsuka Hiromi, Morishima Takkan, Sato Keiji
Department of Orthopaedic Surgery, School of Medicine, Aichi Medical University, 21 Karimata Yazako, Nagakute-cho, Aichi, Japan.
J Orthop Sci. 2012 Mar;17(2):118-23. doi: 10.1007/s00776-011-0180-x. Epub 2011 Dec 22.
Techniques of cemented total hip arthroplasty have developed over time. We present the outcomes of Charnley total hip arthroplasty performed using improved second- and third-generation cementing techniques.
We reviewed the radiologic results of 91 Charnley total hip arthroplasties performed using second- and third-generation cementing techniques. Second-generation techniques involved making multiple anchor holes, a double-cementing method on the acetabular side and an intramedullary plug, and retrograde filling with a cement gun on the femoral side in 57 hips. Third-generation techniques involved additional vacuum mixing and cement pressurization in 34 hips.
Joint survival rates at 20 years when using second-generation techniques were 89% for the socket and 94% for the stem with aseptic loosening as the end point; the survival rates at 10 years when using third-generation techniques were 97 and 100%, respectively. According to our radiographic evaluation system for the clear zone at 5 years, there was less clear zone in the acetabular side with the third-generation techniques than with second-generation techniques. In the femoral side, there was very little development of the clear zone, but the difference between generations was not significant.
Second- and third-generation cementing techniques showed excellent survivorship. The clear zone scores at 5 years indicated that third-generation techniques were effective, especially in the acetabular side, and may produce better long-term results than second-generation techniques.
骨水泥型全髋关节置换术的技术随着时间不断发展。我们展示了采用改良的第二代和第三代骨水泥技术进行Charnley全髋关节置换术的结果。
我们回顾了91例采用第二代和第三代骨水泥技术进行的Charnley全髋关节置换术的放射学结果。第二代技术包括在57髋中制作多个锚孔、髋臼侧采用双骨水泥法和髓内塞，以及股骨侧用骨水泥枪逆行填充。第三代技术包括在34髋中增加真空搅拌和骨水泥加压。
以无菌性松动为终点，采用第二代技术时髋臼在20年时的关节生存率为89%，股骨柄为94%；采用第三代技术时在10年时的生存率分别为97%和100%。根据我们的5年时透明区的放射学评估系统，第三代技术在髋臼侧的透明区比第二代技术少。在股骨侧，透明区进展很少，但两代之间差异不显著。
第二代和第三代骨水泥技术显示出优异的生存率。5年时的透明区评分表明第三代技术有效，尤其是在髋臼侧，可能比第二代技术产生更好的长期结果。
