Heijnens Luc J M, Halma Jelle J, Gaalen Steven M van, Gast Arthur de
Clinical Orthopaedic Research Center - midden Nederland (CORC-mN) , Department of Orthopaedics, Diakonessenhuis Hospital Utrecht/Zeist, Utrecht , the Netherlands .
Acta Orthop. 2014 Aug;85(4):363-7. doi: 10.3109/17453674.2014.934185. Epub 2014 Jun 23.
We evaluated the 5-year survival of the uncemented Optan anatomically adapted femoral stem, with revision for aseptic loosening as the endpoint.
Between January 2004 and March 2007, 432 total hip arthroplasties (THAs) were performed in 432 patients. After follow-up for a mean time of 5 years, the patients were evaluated using the WOMAC questionnaire and plain radiography. Patients who were unable to attend the follow-up visit were contacted by telephone to determine whether they had had any revision surgery of their THA.
Within 5 years, 39 patients (9%) had died of unrelated causes and 63 patients (15%) had been lost to follow-up. Of the remaining cohort, 224 patients (68%) had full follow-up while 88 patients (27%) were evaluated with WOMAC only and 18 patients (5%) were evaluated with radiography only. The mean WOMAC score of all evaluated patients was 21 (10-100). At 5-year follow-up, there were 26 stem revisions reported (6%), 14 hips (3%) showed aseptic loosening, and 12 hips (3%) had had a periprosthetic femoral fracture. The 5-year survival to revision for any reason was 94%. Worst-case analysis yielded a 5-year survival of 79%.
The 5-year survival for aseptic loosening of the Optan anatomically adapted femoral component was disappointing. Radiographic evaluation showed evidence of proximal radiolucencies and distal cortical bone hypertrophy, which we attribute to insufficient proximal bone in-growth and increased load transfer at the tip of the stem. We do not recommend the use of the Optan femoral stem.
我们评估了非骨水泥型Optan解剖型适配股骨柄的5年生存率，以无菌性松动翻修为终点。
2004年1月至2007年3月期间，对432例患者实施了432例全髋关节置换术（THA）。平均随访5年后，使用WOMAC问卷和X线平片对患者进行评估。无法参加随访的患者通过电话联系，以确定他们是否进行了THA的翻修手术。
5年内，39例患者（9%）死于无关原因，63例患者（15%）失访。在其余队列中，224例患者（68%）进行了完整随访，88例患者（27%）仅通过WOMAC进行评估，18例患者（5%）仅通过X线检查进行评估。所有评估患者的WOMAC平均评分为21（10 - 100）。在5年随访时，报告有26例股骨柄翻修（6%），14髋（3%）显示无菌性松动，12髋（3%）发生了假体周围股骨骨折。任何原因导致翻修的5年生存率为94%。最坏情况分析得出5年生存率为79%。
Optan解剖型适配股骨部件无菌性松动的5年生存率令人失望。影像学评估显示近端出现透亮线以及远端皮质骨肥大，我们将其归因于近端骨长入不足以及柄尖处负荷转移增加。我们不建议使用Optan股骨柄。
