Krishnan Harry, Patel Nirav K, Skinner John A, Muirhead-Allwood Sarah K, Briggs Timothy W, Carrington Richard W, Miles Jonathan
The Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, UK.
Hip Int. 2013 May-Jun;23(3):303-9. doi: 10.5301/hipint.5000014. Epub 2013 Jan 17.
Due to an increasing lifespan, patients with osteogenesis imperfecta have a high incidence of hip osteoarthritis. The presence of recurrent fractures and deformities make primary and particularly revision total hip arthroplasty challenging. We present a series of patients with osteogenesis imperfecta undergoing total hip arthroplasty at a tertiary referral centre with a median follow-up of 7.6 years (4 to 35 years). There were four primary total hip arthroplasties and eight revision total hip arthroplasties performed in four patients. Three femoral components were custom computer assisted design computer assisted manufactured. The survival rate of the primary total hip arthroplasty was 16% and there were ten complications: five intraoperative fractures, one case of septic loosening and four cases of aseptic loosening. Patients with pre-operative acetabular protrusio were significantly more likely to require revision surgery (p = 0.02). At latest follow-up, the median Oxford hip score was 41 (37 to 46). As the largest series of primary and revision total hip arthroplasty performed in patients with osteogenesis imperfecta, we report good medium to long-term outcomes. Preoperative planning and consideration of custom made prostheses have an important role in these complex cases.
由于寿命延长，成骨不全患者髋骨关节炎的发病率较高。反复骨折和畸形的存在使得初次全髋关节置换术，尤其是翻修全髋关节置换术具有挑战性。我们报告了一系列在三级转诊中心接受全髋关节置换术的成骨不全患者，中位随访时间为7.6年（4至35年）。4例患者共进行了4例初次全髋关节置换术和8例翻修全髋关节置换术。3个股骨假体采用定制计算机辅助设计和计算机辅助制造。初次全髋关节置换术的生存率为16%，出现了10例并发症：5例术中骨折、1例感染性松动和4例无菌性松动。术前存在髋臼前突的患者更有可能需要翻修手术（p = 0.02）。在最近一次随访时，牛津髋关节评分中位数为41（37至46）。作为对成骨不全患者进行的最大系列的初次和翻修全髋关节置换术，我们报告了良好的中长期结果。术前规划和考虑定制假体在这些复杂病例中具有重要作用。
