Tozun Ismail Remzi, Ozden Vahit Emre, Dikmen Goksel, Beksac Burak
Department of Orthopedics and Traumatology, Acibadem Medical Faculty, Acibadem Maslak Hospital, Maslak, Istanbul, Turkey, 34457,
Int Orthop. 2014 Oct;38(10):2027-31. doi: 10.1007/s00264-014-2387-x. Epub 2014 Jun 1.
The purpose of this study was to evaluate our clinical experience with ceramic-on-ceramic cementless total hip arthroplasty (THA) and complications after an average follow-up of more than eight years.
From January 2001 to December 2008, 540 THA with ceramic-on-ceramic bearings were performed in 448 patients (92 bilateral, 54 of which were operated simultaneously) with a mean age 49.9 years (range 18-84) by a senior surgeon. Pre-operative aetiological reasons were developmental dysplasia of the hip (DDH) in 205 hips, degenerative arthritis in 157 hips, avascular necrosis in 51 hips, rheumatoid diseases in 40 hips, posttraumatic arthritis in 40 hips, other reasons in 25 hips and revision surgery in 22 hips. Patients were evaluated with Harris hip score (HSS), and radiological findings of acetabular and femoral component loosening or osteolysis with ceramic bearing related complications like squeaking, liner and head fractures were recorded.
The average duration of follow-up time was 8.2 years (range, five to 13.2). The main Harris hip score increased from 42.4 points preoperatively to 94.9 points at the time of last follow-up. We had one fracture of the ceramic head, 11 clicking and four squeaking; one of them was revised because of terrible squeaking due to acetabular liner fracture, the other three were seldom audible from the outside and followed conservatively. We did not observed loosening or osteolysis due to ceramic bearings at the time of the final follow-up.
Our study has demonstrated that ceramic-on-ceramic bearings can be used safely in different etiological problems. Incidences of noisy hips are becoming less frequent.
本研究旨在评估我们在平均随访超过八年的情况下，使用陶瓷对陶瓷非骨水泥型全髋关节置换术（THA）的临床经验及并发症情况。
2001年1月至2008年12月，一位资深外科医生为448例患者（92例双侧，其中54例同时进行手术）实施了540例陶瓷对陶瓷关节的THA手术，患者平均年龄49.9岁（范围18 - 84岁）。术前病因包括髋关节发育不良（DDH）205髋、退行性关节炎157髋、股骨头缺血性坏死51髋、类风湿疾病40髋、创伤后关节炎40髋、其他原因25髋以及翻修手术22髋。采用Harris髋关节评分（HSS）对患者进行评估，并记录髋臼和股骨组件松动或骨溶解的影像学表现以及与陶瓷关节相关的并发症，如摩擦声、内衬和股骨头骨折。
平均随访时间为8.2年（范围5至13.2年）。主要Harris髋关节评分从术前的42.4分提高到最后一次随访时的94.9分。我们有1例陶瓷股骨头骨折、11例弹响和4例摩擦声；其中1例因髋臼内衬骨折导致严重摩擦声而进行了翻修，另外3例从外部几乎听不到，采取保守治疗。在最后随访时，我们未观察到因陶瓷关节导致的松动或骨溶解。
我们的研究表明，陶瓷对陶瓷关节可安全用于不同病因问题。髋关节出现杂音的发生率正变得越来越低。
