Hutt Jonathan, Harb Ziad, Gill Ian, Kashif Fadhil, Miller John, Dodd Matthew
Trauma & Orthopaedics, Croydon University Hospital, Croydon, UK.
Int Orthop. 2014 May;38(5):917-22. doi: 10.1007/s00264-013-2212-y. Epub 2013 Dec 10.
The collum femoris preserving (CFP) uncemented prosthesis has a bone-preserving, high subcapital neck resection and a short anatomical stem. The ideal arthroplasty option in the younger, active patient is a subject of some debate. We evaluated midterm outcomes of the CFP in this patient population.
A prospective, consecutive cohort of 75 CFP total hip replacement (THR) patients with a mean age of 52 years was followed for a mean of 9.3 years. Patients were assessed using the Harris Hip Score (HHS). Pain was assessed using a visual analogue scale (VAS) and activity levels using the University of California, Los Angeles (UCLA) score. Radiographs were evaluated for evidence of loosening. Survivorship was calculated with an endpoint of revision for aseptic loosening or radiographic evidence of loosening.
Mean HHS improved from a mean of 50 pre-operatively to 91 (p < 0.001) postoperatively. Mean pain score was 1, mean patient satisfaction was 9 and mean UCLA score was 6. Two acetabular components were revised for aseptic loosening; no stem required revision. Radiographically, no cases had evidence of loosening. Survivorship was 96.8 % for the acetabular component and 100 % for the stem at ten years. Three patients died from unrelated causes, and five were lost to follow-up.
Bone-preserving hip replacement has increased in popularity as hip replacement in younger and more active individuals increases. The CFP prosthesis has excellent midterm clinical function and survival and provides high levels of satisfaction in young patients.
保留股骨颈(CFP)非骨水泥型假体具有保骨、高位头颈切除以及短解剖型柄的特点。对于年轻、活跃的患者而言,理想的关节置换方案仍存在一定争议。我们评估了CFP在该患者群体中的中期疗效。
对75例平均年龄为52岁的CFP全髋关节置换(THR)患者进行前瞻性连续队列研究,随访时间平均为9.3年。采用Harris髋关节评分(HHS)对患者进行评估。使用视觉模拟量表(VAS)评估疼痛,使用加利福尼亚大学洛杉矶分校(UCLA)评分评估活动水平。对X线片进行评估,以确定是否有松动迹象。以无菌性松动翻修或X线片显示松动为终点计算假体生存率。
HHS平均评分从术前的50分提高到术后的91分(p < 0.001)。平均疼痛评分为1分,患者平均满意度为9分,UCLA平均评分为6分。有2例髋臼假体因无菌性松动进行了翻修;无需对柄进行翻修。X线片显示,无病例有松动迹象。髋臼假体10年生存率为96.8%,柄的生存率为100%。3例患者死于无关原因,5例失访。
随着年轻及更活跃个体髋关节置换手术的增加,保骨髋关节置换越来越受欢迎。CFP假体具有出色的中期临床功能和生存率,能为年轻患者提供较高的满意度。