Veldstra Ronald, van Dongen Annemarie, Kraaneveld Eric C
Orthopedic Department, Geminiziekenhuis, Den Helder, The Netherlands.
Hip Int. 2012 May-Jun;22(3):296-301. doi: 10.5301/HIP.2012.9244.
Alumina grit-blasted implants have been widely used in cementless total hip arthroplasty (THA). However, alumina particles can become embedded in the implant surface, leading to deposition in periprosthetic tissues and implant wear. We hypothesised that the alumina-reduced surface BICON-PLUS NT acetabular cup would improve implant fixation and clinical outcomes over the conventional surface BICON-PLUS cup. In a randomised controlled, double-blind study, patients with primary or secondary osteoarthritis requiring primary arthroplasty were randomly assigned to THA with either the BICON-PLUS or BICON-PLUS NT cup. All cups were combined with the SL-PLUS stem. In addition to clinical and radiographic assessments, dual-energy X-absorptiometry (DEXA) was performed preoperatively and at regular intervals during a planned 2-year follow-up period to measure bone mineral density as a marker of implant fixation. At 1 year, there were no differences in bone mineral density, or in clinical or radiographic outcomes between the BICON-PLUS and BICON-PLUS NT groups were identified, leading to early termination of the study. Both groups showed excellent clinical improvement and there were few complications. Both the alumina-reduced and conventional surface acetabular cups can be used with confidence in primary THA for osteoarthritis, although longer-term studies are required to confirm these findings.
氧化铝喷砂处理的植入物已广泛应用于非骨水泥型全髋关节置换术（THA）。然而，氧化铝颗粒可能会嵌入植入物表面，导致在假体周围组织中沉积并造成植入物磨损。我们推测，与传统表面的BICON-PLUS髋臼杯相比，表面氧化铝减少的BICON-PLUS NT髋臼杯能改善植入物固定及临床效果。在一项随机对照双盲研究中，需要进行初次关节置换术的原发性或继发性骨关节炎患者被随机分配接受使用BICON-PLUS杯或BICON-PLUS NT杯的THA手术。所有髋臼杯均与SL-PLUS股骨柄配合使用。除了临床和影像学评估外，在计划的2年随访期内，术前及定期进行双能X线吸收法（DEXA）检测以测量骨密度，作为植入物固定的指标。1年后，BICON-PLUS组和BICON-PLUS NT组在骨密度、临床或影像学结果方面均无差异，导致该研究提前终止。两组均显示出良好的临床改善，且并发症较少。对于骨关节炎的初次THA手术，表面氧化铝减少的髋臼杯和传统表面髋臼杯均可放心使用，不过仍需要长期研究来证实这些结果。
