OrthoCarolina, Concord, North Carolina.
Lexington Clinic Orthopedics-Sports Medicine Center, Lexington, Kentucky.
J Arthroplasty. 2014 Jun;29(6):1285-8. doi: 10.1016/j.arth.2013.12.024. Epub 2013 Dec 21.
Between 2001 and 2011, 1168 revision hip arthroplasties were reviewed for "early" failures within 5 years of the primary total hip arthroplasty (THA). 24.1% underwent revision within 5 years of index THA. Aseptic loosening, infection, instability, metallosis, and fracture were common modes of failure. In our previous report from 1986 to 2000, 33% were "early" revisions, with instability and aseptic loosening accounting for over 70% of these early failures. While the proportion of "early" revisions decreased 9% from our previous report, this rate remains alarming. The emergence of metallosis and aseptic loosening of monoblock metal on metal shells as leading causes of early failures is concerning. This report suggests caution in the early adoption of new innovations before evidence based medicine is available to justify the risk of their use.
在 2001 年至 2011 年期间，对 1168 例初次全髋关节置换术后 5 年内发生的“早期”失败进行了回顾。24.1%的患者在初次 THA 后 5 年内接受了翻修。无菌性松动、感染、不稳定、金属中毒和骨折是常见的失败模式。在我们之前 1986 年至 2000 年的报告中，33%为“早期”翻修，其中不稳定和无菌性松动占这些早期失败的 70%以上。虽然与我们之前的报告相比，“早期”翻修的比例下降了 9%，但这一比例仍然令人震惊。金属中毒和单体金属对金属外壳的无菌性松动作为早期失败的主要原因令人担忧。本报告建议在基于证据的医学出现之前，谨慎采用新的创新技术，以证明其使用风险是合理的。
