Streit Marcus R, Weiss Stefan, Andreas Franziska, Bruckner Thomas, Walker Tilman, Kretzer J Philippe, Ewerbeck Volker, Merle Christian
Department of Orthopaedic and Trauma Surgery.
Acta Orthop. 2014 Aug;85(4):368-74. doi: 10.3109/17453674.2014.925351. Epub 2014 May 30.
Uncemented acetabular components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the second decade in young and active patients. We report on a minimum 10-year follow-up of an uncemented press-fit acetabular component that is still in clinical use.
We examined the clinical and radiographic results of our first 121 consecutive cementless THAs using a cementless, grit-blasted, non-porous, titanium alloy press-fit cup (Allofit; Zimmer Inc., Warsaw, IN) without additional screw fixation in 116 patients. Mean age at surgery was 51 (21-60) years. Mean time of follow-up evaluation was 11 (10-12) years.
At final follow-up, 8 patients had died (8 hips), and 1 patient (1 hip) was lost to follow-up. 3 hips in 3 patients had undergone acetabular revision, 2 for deep infection and 1 for aseptic acetabular loosening. There were no impending revisions at the most recent follow-up. We did not detect periacetabular osteolysis or loosening on plain radiographs in those hips that were evaluated radiographically (n = 90; 83% of the hips available at a minimum of 10 years). Kaplan-Meier survival analysis using revision of the acetabular component for any reason (including isolated inlay revisions) as endpoint estimated the 11-year survival rate at 98% (95% CI: 92-99).
Uncemented acetabular fixation using the Allofit press-fit cup without additional screws was excellent into early in the second decade in this young and active patient cohort. The rate of complications related to the liner and to osteolysis was low.
非骨水泥型髋臼假体在初次全髋关节置换术（THA）中如今被广泛应用，但很少有研究评估其在年轻活跃患者中至第二个十年的生存率。我们报告了一种仍在临床使用的非骨水泥压配型髋臼假体至少10年的随访结果。
我们检查了连续121例初次非骨水泥THA的临床和影像学结果，这些患者使用的是一种非骨水泥、喷砂处理、无孔的钛合金压配杯（Allofit；Zimmer公司，印第安纳州华沙），116例患者未额外使用螺钉固定。手术时的平均年龄为51（21 - 60）岁。平均随访评估时间为11（10 - 12）年。
在末次随访时，8例患者死亡（8髋），1例患者（1髋）失访。3例患者的3髋进行了髋臼翻修，2例因深部感染，1例因无菌性髋臼松动。在最近一次随访时没有即将进行翻修的情况。在接受影像学评估的髋部（n = 90；占至少10年时可评估髋部的83%）的平片上，我们未检测到髋臼周围骨溶解或松动。以因任何原因（包括单纯嵌体翻修）对髋臼假体进行翻修为终点的Kaplan - Meier生存分析估计，11年生存率为98%（95%CI：92 - 99）。
在这个年轻活跃的患者队列中，使用Allofit压配杯且未额外使用螺钉的非骨水泥髋臼固定在第二个十年早期效果良好。与衬垫和骨溶解相关的并发症发生率较低。
