Department of Surgery, Section of Orthopaedics and Traumatology, The University of Catania, Via Plebiscito 628, 95100, Catania, Italy.
Bone Joint J. 2014 Apr;96-B(4):455-61. doi: 10.1302/0301-620X.96B4.32607.
In 2012 we reviewed a consecutive series of 92 uncemented THRs performed between 1986 and 1991 at our institution using the CLS Spotorno stem, in order to assess clinical outcome and radiographic data at a minimum of 21 years. The series comprised 92 patients with a mean age at surgery of 59.6 years (39 to 77) (M:F 43;49). At the time of this review, seven (7.6%) patients had died and two (2.2%) were lost to follow-up. The 23-year Kaplan-Meier survival rates were 91.5% (95% confidence intervals (CI) 85.4% to 97.6%; 55 hips at risk) and 80.3% (95% CI, 71.8% to 88.7%; 48 hips at risk) respectively, with revision of the femoral stem or of any component as endpoints. At the time of this review, 76 patients without stem revision were assessed clinically and radiologically (mean follow-up 24.0 years (21.5 to 26.5)). For the 76 unrevised hips the mean Harris hip score was 87.1 (65 to 97). Femoral osteolysis was detected in five hips (6.6%) only in Gruen zone 7. Undersized stems were at higher risk of revision owing to aseptic loosening (p = 0.0003). Patients implanted with the stem in a varus position were at higher risk of femoral cortical hypertrophy and thigh pain (p = 0.0006 and p = 0.0007, respectively). In our study, survival, clinical outcome and radiographic data remained excellent in the third decade after implantation. Nonetheless, undersized stems were at higher risk of revision owing to aseptic loosening.
2012 年，我们回顾了在我们机构使用 CLS Spotorno 柄进行的 92 例非骨水泥 THR 的连续系列，这些患者在 1986 年至 1991 年之间接受了手术，以评估至少 21 年的临床结果和影像学数据。该系列包括 92 名患者，手术时的平均年龄为 59.6 岁（39 至 77 岁）（M:F 43;49）。在本次回顾时，7 名（7.6%）患者死亡，2 名（2.2%）患者失访。23 年的 Kaplan-Meier 生存率分别为 91.5%（95%置信区间（CI）85.4%至 97.6%；55 髋有风险）和 80.3%（95%CI，71.8%至 88.7%；48 髋有风险），以股骨柄或任何部件的翻修为终点。在本次回顾时，76 名未行股骨柄翻修的患者进行了临床和影像学评估（平均随访 24.0 年（21.5 至 26.5 年））。对于 76 例未行翻修的髋关节，平均 Harris 髋关节评分（HHS）为 87.1（65 至 97）。仅在 7 区发现 5 髋（6.6%）股骨骨溶解。由于无菌性松动，尺寸较小的柄翻修风险更高（p = 0.0003）。以矢状面角度植入的患者，股骨皮质肥大和大腿疼痛的风险更高（p = 0.0006 和 p = 0.0007）。在我们的研究中，植入后第三个十年的生存、临床结果和影像学数据仍然非常出色。尽管如此，由于无菌性松动，尺寸较小的柄翻修风险更高。
