Philpott A, Weston-Simons J S, Grammatopoulos G, Bejon P, Gill H S, McLardy-Smith P, Gundle R, Murray D W, Pandit H
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK.
Maturitas. 2014 Feb;77(2):185-90. doi: 10.1016/j.maturitas.2013.10.019. Epub 2013 Nov 7.
The burden of revision total hip replacement (THR) surgery is increasing. With an increasing life expectancy and younger age of primary surgery this trend is set to continue. There are few data on the long-term outcome of revision THR. This retrospective study of 1176 consecutive revision THRs with a minimum 10-year follow-up from a University Teaching Hospital was undertaken to review implant survival and patient reported outcomes. Mean follow-up was 11 years with implant survival at 10 years of 82% (CI: 80-85). Implant survival varied between 58% (unexplained pain) to 84% (aseptic loosening) depending on the indication for revision surgery. Positive predictors of survival were age greater than 70 at the time of surgery (p=0.011), revision for aseptic loosening (p<0.01) and revision of both components or just the acetabular component (p<0.01). At the last review, mean Oxford Hip Score (OHS) was 34 (SD: 11.3) and 92% of the living patients with unrevised hips were satisfied with the outcome of revision surgery. This long term study has demonstrated that positive predictors of survival and outcome of revision THR surgery are age greater than 70 years, revision for aseptic loosening and component revision. This should aid surgeons in their counselling of patients prior to surgery.
翻修全髋关节置换术（THR）的负担正在增加。随着预期寿命的延长和初次手术患者年龄的降低，这一趋势将持续下去。关于翻修THR的长期结果的数据很少。本研究对一家大学教学医院连续进行的1176例翻修THR进行回顾性研究，进行了至少10年的随访，以评估植入物生存率和患者报告的结局。平均随访时间为11年，10年时植入物生存率为82%（置信区间：80-85）。根据翻修手术的指征，植入物生存率在58%（不明原因疼痛）至84%（无菌性松动）之间变化。生存的阳性预测因素包括手术时年龄大于70岁（p=0.011）、因无菌性松动进行翻修（p<0.01）以及翻修两个组件或仅翻修髋臼组件（p<0.01）。在最后一次评估时，平均牛津髋关节评分（OHS）为34（标准差：11.3），92%未翻修髋关节的存活患者对翻修手术的结果感到满意。这项长期研究表明，翻修THR手术生存和结局的阳性预测因素是年龄大于70岁、因无菌性松动进行翻修和组件翻修。这将有助于外科医生在手术前对患者进行咨询。
