Silverton Craig D, Jacobs Joshua J, Devitt Jeffrey W, Cooper H John
Department of Orthopaedic Surgery, Henry Ford Hospital, Henry Ford Health System, Detroit, Michigan.
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
J Arthroplasty. 2014 Sep;29(9):1768-73. doi: 10.1016/j.arth.2014.04.039. Epub 2014 May 4.
Modular neck femoral stems have a higher-than-anticipated rate of failure in registry results, but large single-center cohort studies are lacking. This is a retrospective cohort of 152 hips implanted with a single titanium stem with a modular titanium neck, presenting clinical, radiographic, and metal ion results at a mean 4.5-year follow-up. Five hips were revised during the study period, for an overall Kaplan-Meier survival of 0.894 at 8 years. There was one modular neck fracture (0.66%), but others demonstrated corrosion or adverse tissue reaction. Serum metal levels demonstrated wide variability. Despite good clinical results in the majority of patients, we confirmed an increased rate of femoral revision at mid-term follow-up, and therefore urge caution in the use of this particular stem design.
在登记结果中,模块化股骨柄的失败率高于预期,但缺乏大型单中心队列研究。这是一项回顾性队列研究,纳入了152例植入单一钛制柄和模块化钛制颈的髋关节,在平均4.5年的随访中呈现了临床、影像学和金属离子结果。在研究期间,有5例髋关节进行了翻修,8年时的总体Kaplan-Meier生存率为0.894。发生了1例模块化颈骨折(0.66%),但其他病例表现为腐蚀或不良组织反应。血清金属水平显示出很大的变异性。尽管大多数患者临床结果良好,但我们证实在中期随访时股骨翻修率增加,因此在使用这种特定的柄设计时需谨慎。