Bigsby Ewan, Whitehouse Michael R, Bannister Gordon C, Blom Ashley W
Avon Orthopaedic Centre, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
Hip Int. 2012 Sep-Oct;22(5):505-10. doi: 10.5301/HIP.2012.9746.
Recurrent dislocation requiring revision surgery occurs in approximately 4% of primary total hip arthroplasties (THAs). To reduce this risk, or to treat those patients who recurrently dislocate, a constrained acetabular component may be used, however there are concerns over the success of such components due to increased mechanical stresses. The purpose of this study was to analyse the survivorship and radiological results for the Omnifit constrained acetabular component, providing a longer patient reported outcome follow-up than previous studies. 117 patients (median age 82 years) underwent a THA with an Omnifit constrained acetabular component. Of these, 45 were primary replacements and 72 were revisions. Survivorship analysis was performed and patients were assessed both radiologically and functionally. At follow-up, 53 patients (45.3%) had died at a median time of 33 months from operation. The median overall follow-up was 7.0 (5.5-8.2) years. Survivors (median age 83 years) reported a median Oxford Hip Score (OHS) of 16.6 (0-48), 87.8% were satisfied with their surgery. 45 (91.8%) of the acetabular components were stable radiologically, 48 (96%) of the femoral components were stable (5 uncemented, 43 cemented) and two possibly unstable. Four of the 117 patients underwent further surgery. Only one required revision of the prosthesis and this was for a periprosthetic fracture. In the medium term the Omnifit constrained acetabular component prevents dislocation and does not cause excessive loosening of either the acetabular or femoral components in our patient population. Our results support the use of the Omnifit constrained acetabular component in elderly patients at risk of dislocation with low functional demand.
在初次全髋关节置换术（THA）中，约4%的患者会出现需要翻修手术的复发性脱位。为降低这种风险，或治疗那些反复脱位的患者，可使用限制性髋臼组件，然而，由于机械应力增加，人们对这类组件的成功率存在担忧。本研究的目的是分析Omnifit限制性髋臼组件的生存率和影像学结果，提供比以往研究更长的患者报告结局随访时间。117例患者（中位年龄82岁）接受了使用Omnifit限制性髋臼组件的THA。其中，45例为初次置换，72例为翻修。进行了生存率分析，并对患者进行了影像学和功能评估。随访时，53例患者（45.3%）已死亡，中位死亡时间为术后33个月。中位总随访时间为7.0（5.5 - 8.2）年。存活患者（中位年龄83岁）报告的牛津髋关节评分（OHS）中位数为16.6（0 - 48），87.8%的患者对手术满意。45个（91.8%）髋臼组件在影像学上稳定，48个（96%）股骨组件稳定（5个非骨水泥型，43个骨水泥型），2个可能不稳定。117例患者中有4例接受了进一步手术。只有1例需要翻修假体，原因是假体周围骨折。从中期来看，Omnifit限制性髋臼组件可防止脱位，在我们的患者群体中不会导致髋臼或股骨组件过度松动。我们的结果支持在功能需求低、有脱位风险的老年患者中使用Omnifit限制性髋臼组件。
