Thomsen Per B, Dalsgaard Jesper, Vainorius Dovydas, Hansen Torben Bæk
Orthopaedic Research Unit, Holstebro Regional Hospital, Holstebro, Denmark.
Dan Med J. 2013 Aug;60(8):A4671.
As the only femoral stem, the Exeter stem has shown acceptable results with Boneloc cement, but no long-term results have been published. The aim of this study was to evaluate the 20-year performance of Boneloc-cemented primary Exeter hip arthroplasty.
From March 1992 to June 1994, a total of 200 consecutive Boneloc-cemented primary hip arthroplasties were performed in 183 patients aged 26-90 years, mean 71 years. At follow-up after 18-20 years, the primary endpoint was prosthetic survival assessed by the Kaplan-Meier analysis. Secondary endpoints were clinical and radiographic follow-up examination.
After a mean 18.4 (17.6-19.6)-year period, 27 patients/32 hips had been revised. At endpoint revision for any reason the 20-year cumulative overall survival was 73% (95% confidence interval (CI): 49-89%); at endpoint revision for aseptic loosening the 20-year cumulative survival was 84% (95% CI: 68-96%) for the stem and 76% (95% CI: 61-92%) for the cup. Cementing technique, implant size and metal backing of the cup were not associated with revision rates. A total of 23 patients/24 hips had clinical/radiographic examination, and 10 patients/12 hips were assessed by telephone. According to patient reported evaluation, all were very satisfied or satisfied. Radiographs showed loosening of two cups and possible loosening of two stems.
This study provides the first long-term results on Boneloc-cemented primary hip arthroplasty. The Exeter prosthesis, especially the stem, maintains the previously published acceptable survival and results despite the documented inferior quality of the cement.
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作为唯一的股骨柄，埃克塞特柄在使用骨水泥固定时已显示出可接受的结果，但尚无长期结果发表。本研究的目的是评估骨水泥固定的初次埃克塞特髋关节置换术20年的性能。
1992年3月至1994年6月，对183例年龄在26 - 90岁（平均71岁）的患者连续进行了200例骨水泥固定的初次髋关节置换术。在18 - 20年的随访中，主要终点是通过Kaplan - Meier分析评估的假体生存率。次要终点是临床和影像学随访检查。
平均随访18.4（17.6 - 19.6）年后，27例患者/32髋进行了翻修。在因任何原因进行终点翻修时，20年累积总生存率为73%（95%置信区间（CI）：49 - 89%）；在因无菌性松动进行终点翻修时，柄的20年累积生存率为84%（95%CI：68 - 96%），髋臼杯为76%（95%CI：61 - 92%）。骨水泥固定技术、植入物尺寸和髋臼杯的金属衬背与翻修率无关。共有23例患者/24髋进行了临床/影像学检查，10例患者/12髋通过电话进行了评估。根据患者报告的评估，所有人都非常满意或满意。影像学检查显示两个髋臼杯松动，两个柄可能松动。
本研究提供了骨水泥固定的初次髋关节置换术的首个长期结果。尽管有文献记载骨水泥质量较差，但埃克塞特假体，尤其是柄，仍保持了先前发表的可接受的生存率和结果。
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