Burston B J, Barnett A J, Amirfeyz R, Yates P J, Bannister G C
Avon Orthopaedic Centre, Westbury-on-Trym, Bristol BS10 5NB, UK.
J Bone Joint Surg Br. 2012 Jul;94(7):889-94. doi: 10.1302/0301-620X.94B7.28799.
We prospectively followed 191 consecutive collarless polished tapered (CPT) femoral stems, implanted in 175 patients who had a mean age at operation of 64.5 years (21 to 85). At a mean follow-up of 15.9 years (14 to 17.5), 86 patients (95 hips) were still alive. The fate of all original stems is known. The 16-year survivorship with re-operation for any reason was 80.7% (95% confidence interval 72 to 89.4). There was no loss to follow-up, with clinical data available on all 95 hips and radiological assessment performed on 90 hips (95%). At latest follow-up, the mean Harris hip score was 78 (28 to 100) and the mean Oxford hip score was 36 (15 to 48). Stems subsided within the cement mantle, with a mean subsidence of 2.1 mm (0.4 to 19.2). Among the original cohort, only one stem (0.5%) has been revised due to aseptic loosening. In total seven stems were revised for any cause, of which four revisions were required for infection following revision of the acetabular component. A total of 21 patients (11%) required some sort of revision procedure; all except three of these resulted from failure of the acetabular component. Cemented acetabular components had a significantly lower revision burden (three hips, 2.7%) than Harris Galante uncemented components (17 hips, 21.8%) (p < 0.001). The CPT stem continues to provide excellent radiological and clinical outcomes at 15 years following implantation. Its results are consistent with other polished tapered stem designs.
我们前瞻性地随访了191例连续植入无领抛光锥形(CPT)股骨柄的患者,这些患者共175例,手术时的平均年龄为64.5岁(21至85岁)。平均随访15.9年(14至17.5年)后,86例患者(95髋)仍然存活。所有原始股骨柄的转归情况均已知晓。因任何原因再次手术的16年生存率为80.7%(95%置信区间72至89.4)。无失访情况,所有95髋均有临床数据,90髋(95%)进行了影像学评估。在最近一次随访时,Harris髋关节平均评分为78分(28至100分),牛津髋关节平均评分为36分(15至48分)。股骨柄在骨水泥壳内发生下沉,平均下沉2.1毫米(0.4至19.2毫米)。在最初的队列中,仅1个股骨柄(0.5%)因无菌性松动而进行了翻修。总共7个股骨柄因任何原因进行了翻修,其中4例翻修是由于髋臼部件翻修后感染所致。共有21例患者(11%)需要某种翻修手术;除3例之外,所有这些均因髋臼部件失败所致。骨水泥固定的髋臼部件的翻修负担(3髋,2.7%)明显低于Harris Galante非骨水泥固定部件(17髋,21.8%)(p<0.001)。CPT股骨柄在植入后15年继续提供出色的影像学和临床结果。其结果与其他抛光锥形柄设计一致。