Specialist Orthopaedic Group, Suite 1.08, 3-9 Gillies Street, North Sydney, NSW 2060, Australia.
J Bone Joint Surg Am. 2012 Jan 18;94(2):138-44. doi: 10.2106/JBJS.J.00331.
Alumina ceramic-on-ceramic bearings have gained popularity in hip arthroplasty because of their properties of low wear and chemical inertness. In a previous study, we reported the excellent clinical results in a series of cementless ceramic-on-ceramic primary total hip arthroplasties at a minimum of five years of follow-up. The purpose of the present study was to determine the results in the same patient cohort at a minimum of ten years of follow-up.
A series of 301 consecutive primary cementless total hip arthroplasties was assessed clinically and radiographically. Clinical information was available for 244 hips in 227 surviving patients at a minimum of ten years of follow-up, and radiographic information was available for 184 hips in 172 patients.
Twenty-six (9.2%) of the patients had died of an unrelated cause and eight (2.7%) had undergone revision arthroplasty by the time of the latest follow-up. The average Harris hip score was 94 points, with 95% (232) of the patients having an excellent or good result and <4% (nine) having moderate residual pain. All radiographic assessments showed evidence of stable osseous ingrowth. Nine revisions had been performed, including four femoral component revisions due to periprosthetic fracture, one femoral revision due to aseptic loosening, one femoral revision secondary to a femoral shortening osteotomy for nerve palsy, two acetabular cup revisions due to psoas tendinitis, and a repeat revision in one of the patients with psoas tendinitis due to acetabular osteolysis. The overall survival rate of the implants was 98% (95% confidence interval, 94.2% to 99.6%) at ten years with revision for any reason as the end point.
The patients in our series had a good implant survival rate, good function, a low implant wear rate as reported in the previous study, and no further radiographic evidence of failure at ten years after cementless primary total hip arthroplasty with alumina ceramic-on-ceramic bearings.
氧化铝陶瓷-陶瓷关节轴承因其低磨损和化学惰性等特性，在髋关节置换术中得到了广泛应用。在之前的研究中，我们报告了一组非骨水泥陶瓷-陶瓷初次全髋关节置换术的优秀临床结果，随访时间至少为 5 年。本研究的目的是在同一患者队列中，至少随访 10 年，确定其结果。
对 301 例连续的初次非骨水泥全髋关节置换术进行了临床和影像学评估。在至少 10 年的随访中，临床资料可用于 227 例存活患者的 244 髋，影像学资料可用于 172 例患者的 184 髋。
26 例（9.2%）患者因非相关原因死亡，8 例（2.7%）患者在最后一次随访时接受了关节翻修。平均 Harris 髋关节评分为 94 分，95%（232 髋）患者的结果为优或良，<4%（9 髋）患者有中度残留疼痛。所有影像学评估均显示稳定的骨质长入。共进行了 9 次翻修，其中 4 次为股骨假体周围骨折，1 次为股骨无菌性松动，1 次为神经麻痹所致股骨短缩截骨的股骨翻修，2 次为因腰大肌肌腱炎导致的髋臼杯翻修，1 次为腰大肌肌腱炎导致髋臼骨溶解的重复翻修。以任何原因翻修为终点，10 年时假体的总体存活率为 98%（95%置信区间，94.2%至 99.6%）。
在我们的研究中，患者的假体存活率较高，功能良好，与之前的研究报道的磨损率低，非骨水泥初次全髋关节置换术后 10 年，陶瓷-陶瓷关节轴承无进一步的影像学失败证据。
