Specialist Orthopaedic Group, Wollstonecraft, NSW, Australia.
J Arthroplasty. 2013 Apr;28(4):650-3. doi: 10.1016/j.arth.2012.07.032. Epub 2012 Nov 7.
The use of large diameter metal bearing total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) increased in popularity in the last decade. More recent literature has highlighted the effect of head size in patient outcomes. Data was obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOA-NJRR) to evaluate the Birmingham (MoM) bearing surface when used with THA and HRA. There is no difference in the overall rate of revision between the THA and HRA but head size has a significant effect on revision rate. The data show that small diameter metal bearings in HRA (below 50mm) have a higher rate of revision than large diameter metal bearings in HRA (equal to and above 50mm) (P<.001). Conversely the large diameter metal bearings in THA have a higher rate of revision than the small diameter metal bearings in THA (P=.027). The revision rate for large diameter HRA compared to small diameter THA is not significantly different P=.670. We recommend caution when choosing either a large diameter (≥50mm) metal on metal THA or small diameter (<50mm) HRA.
在过去十年中，大直径金属轴承全髋关节置换术（THA）和髋关节表面置换术（HRA）的使用越来越普及。最近的文献强调了头大小对患者结果的影响。我们从澳大利亚骨科协会国家关节置换登记处（AOA-NJRR）获取数据，以评估 Birmingham（MoM）轴承表面在 THA 和 HRA 中的应用。THA 和 HRA 的总体翻修率没有差异，但头大小对翻修率有显著影响。数据显示，HRA 中小直径金属轴承（<50mm）的翻修率高于 HRA 中较大直径金属轴承（等于或大于 50mm）（P<.001）。相反，THA 中大直径金属轴承的翻修率高于 THA 中小直径金属轴承（P=.027）。HRA 大直径与 THA 小直径相比，翻修率没有显著差异（P=.670）。我们建议在选择大直径（≥50mm）金属对金属 THA 或小直径（<50mm）HRA 时要谨慎。
