Sarıkaya Baran, Ataoğlu Baybars, Görmeli Gökay, Öztürk Burak Yağmur, Turanlı Sacit
Kazan Devlet Hastanesi Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye.
Eklem Hastalik Cerrahisi. 2013;24(2):91-5. doi: 10.5606/ehc.2013.21.
This study aims to investigate the mid-term clinical and radiological results of cementless hydroxyapatite coated total hip arthroplasty (THA) for hip osteoarthritis due to developmental dysplasia of the hip (DDH).
Between January 2004 and December 2010, 34 hips (12 Crowe type I, 12 Crowe type II, 4 Crowe type III, 6 Crowe type IV) of 30 patients (22 females, 8 males; mean age 53.4 years; range 30 to 75 years) with degenerative arthritis due to DDH were analyzed in terms of cementless hydroxyapatite coated acetabular component (EPF Plus(®)) over Zweymüller femoral component (Zweymüller SL-PLUS(®)) and porous coating. Clinical assessment was performed using Harris hip scores (HHS) preoperatively and at the last clinic visit, while radiological assessment was done according to the Callaghan and Engh's criteria.
The mean follow-up was 48 months (range, 25-91 months). The mean HHS was 44.97 (28-55) preoperatively and 92.25 (69-100) at the last visit. All femoral components were graded as stable according to Callaghan and Engh's criteria. Radiolucency was mostly observed in Gruen zones 1 and zone 7 of the femur [zone 1; 20 hips zone 7; 19 hips zone 2; one hip, zone 3; one hip and zone 6 one hip]. Around acetabular component, radiolucency was detected in zone 2 in 12 hips, zone 3 in 10 hips and zone 1 in six hips. Heterotopic ossification developed in two hips, while neuropraxy was detected in two hips postoperatively. Femoral fissure in one hip, nonunion in the femoral osteotomy line in one hip, and femoral head autograft nonunion in one hip developed.
Mid-term results of uncemented Zweymüller femoral stem and hydroxyapatite coated press-fit using acetabular components for THA femoral stem are excellent.
本研究旨在探讨无骨水泥羟基磷灰石涂层全髋关节置换术（THA）治疗发育性髋关节发育不良（DDH）所致髋关节骨关节炎的中期临床和影像学结果。
2004年1月至2010年12月期间，对30例（22例女性，8例男性；平均年龄53.4岁；范围30至75岁）因DDH导致退行性关节炎的患者的34个髋关节（12个Crowe I型，12个Crowe II型，4个Crowe III型，6个Crowe IV型）进行分析，使用无骨水泥羟基磷灰石涂层髋臼组件（EPF Plus(®)）和Zweymüller股骨组件（Zweymüller SL-PLUS(®)）以及多孔涂层。术前和最后一次门诊就诊时使用Harris髋关节评分（HHS）进行临床评估，同时根据Callaghan和Engh标准进行影像学评估。
平均随访48个月（范围25 - 91个月）。术前平均HHS为44.97（28 - 55），最后一次就诊时为92.25（69 - 100）。根据Callaghan和Engh标准，所有股骨组件均评定为稳定。股骨透亮区主要出现在Gruen 1区和7区[1区；20个髋关节，7区；19个髋关节，2区；1个髋关节，3区；1个髋关节，6区；1个髋关节]。髋臼组件周围，2区有12个髋关节出现透亮区，3区有10个髋关节，1区有6个髋关节。2个髋关节发生异位骨化，术后2个髋关节检测到神经失用。1个髋关节出现股骨裂缝，1个髋关节股骨截骨线不愈合，1个髋关节股骨头自体骨移植不愈合。
THA股骨柄采用非骨水泥型Zweymüller股骨柄和羟基磷灰石涂层压配髋臼组件的中期结果极佳。
