骨水泥型 Müller 直柄全髋关节置换术：18 年生存率、临床及影像学结果。
Cemented Müller straight stem total hip replacement: 18 year survival, clinical and radiological outcomes.
作者信息
Nikolaou Vasileios S, Korres Demetrios, Lallos Stergios, Mavrogenis Andreas, Lazarettos Ioannis, Sourlas Ioannis, Efstathopoulos Nicolas
机构信息
Vasileios S Nikolaou, Stergios Lallos, Ioannis Lazarettos, Ioannis Sourlas, Nicolas Efstathopoulos, 2 Orthopaedic Department, Athens University, 15124 Athens, Greece.
出版信息
World J Orthop. 2013 Oct 18;4(4):303-8. doi: 10.5312/wjo.v4.i4.303. eCollection 2013.
AIM
To present the 18 year survival and the clinical and radiological outcomes of the Müller straight stem, cemented, total hip arthroplasty (THA).
METHODS
Between 1989 and 2007, 176 primary total hip arthroplasties in 164 consecutive patients were performed in our institution by the senior author. All patients received a Müller cemented straight stem and a cemented polyethylene liner. The mean age of the patients was 62 years (45-78). The diagnosis was primary osteoarthritis in 151 hips, dysplasia of the hip in 12 and subcapital fracture of the femur in 13. Following discharge, serial follow-up consisted of clinical evaluation based on the Harris Hip Score and radiological assessment. The survival of the prosthesis using revision for any reason as an end-point was calculated by Kaplan-Meier analysis.
RESULTS
Twenty-four (15%) patients died during the follow-up study, 6 (4%) patients were lost, while the remaining 134 patients (141 hips) were followed-up for a mean of 10 years (3-18 years). HSS score at the latest follow-up revealed that 84 hips (59.5%) had excellent results, 30 (22.2%) good, 11 (7.8%) fair and 9 (6.3%) poor. There were 3 acetabular revisions due to aseptic loosening. Six (4.2%) stems were diagnosed as having radiographic definitive loosening; however, only 1 was revised. 30% of the surviving stems showed no radiological changes of radiolucency, while 70% showed some changes. Survival of the prosthesis for any reason was 96% at 10 years and 81% at 18 years.
CONCLUSION
The 18 year survival of the Müller straight stem, cemented THA is comparable to those of other successful cemented systems.
目的
介绍采用骨水泥固定的 Müller 直柄全髋关节置换术（THA）18 年的生存率以及临床和影像学结果。
方法
1989 年至 2007 年期间，资深作者在我们机构为 164 例连续患者实施了 176 例初次全髋关节置换术。所有患者均接受了 Müller 骨水泥直柄和骨水泥聚乙烯内衬。患者的平均年龄为 62 岁（45 - 78 岁）。诊断为原发性骨关节炎 151 髋，髋关节发育不良 12 髋，股骨颈骨折 13 髋。出院后，系列随访包括基于 Harris 髋关节评分的临床评估和影像学评估。以任何原因翻修为终点，采用 Kaplan-Meier 分析计算假体生存率。
结果
在随访研究期间，24 例（15%）患者死亡，6 例（4%）患者失访，其余 134 例患者（141 髋）平均随访 10 年（3 - 18 年）。最新随访时的 Harris 髋关节评分显示，84 髋（59.5%）结果为优，30 髋（22.2%）为良，11 髋（7.8%）为中，9 髋（6.3%）为差。因无菌性松动进行了 3 例髋臼翻修。6 例（4.2%）柄被诊断为有影像学明确松动；然而，仅 1 例进行了翻修。30%存活的柄未显示透亮线的影像学改变，而 70%显示有一些改变。假体因任何原因的生存率在 10 年时为 96%，在 18 年时为 81%。
结论
采用骨水泥固定的 Müller 直柄全髋关节置换术 18 年的生存率与其他成功的骨水泥固定系统相当。
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