Pace Thomas B, Prather Brad, Burnikel Brian, Shirley Brayton, Tanner Stephanie, Snider Rebecca
Greenville Health System Department of Orthopaedics, 701 Grove Road, Greenville, SC 29607, USA ; GHS, Orthopaedic Surgery, University of South Carolina SOM, Greenville Health System, P.O. Box 27114, Greenville, SC 29616, USA.
Hendricks Orthopedics and Sports Medicine, 300 Hospital Lane Suite 300, Danville, IN 46122, USA.
ISRN Orthop. 2013 Aug 12;2013:632126. doi: 10.1155/2013/632126. eCollection 2013.
This is a retrospective review of 243 hip arthroplasties treated with either hemiarthroplasty (61 surgeries-Group 1) or total hip arthroplasty (182 surgeries-Group 2). The mid- to long-term results of relatively similar, predominately young patient cohorts were assessed annually via radiographs and the Harris Hip Scores for pain and clinical function. Groin pain persisted in 16.4% of Group 1 and 5.5% of Group 2 (P = 0.0159). Thigh pain persisted in 11.5% of Group 1 and 2.2% of Group 2 (P = 0.0078). Complications in Group 1 were 4/61 including 2 revisions with an overall survival rate of 96.7% versus Group 2 complication rate of 29/182 with 15 revisions and an overall survival rate of 91.8%. There were no cases of acetabular protrusio in Group 1, but 2 cases (1%) in Group 2 had cup loosening or osteolysis. Two cases were revised in Group 1 (3.2%). Both were undersized femoral stems. The fifteen revisions (8.2%) in Group 2 included loose stem (1), instability (8), infections (3), cup loosening (2), and accelerated polyethylene wear (1). Hemiarthroplasty has a higher incidence of thigh and groin pain but fewer complications compared with total hip arthroplasty.
这是一项对243例髋关节置换术的回顾性研究，这些手术采用半髋关节置换术（61例手术 - 第1组）或全髋关节置换术（182例手术 - 第2组）进行治疗。通过X线片以及用于评估疼痛和临床功能的Harris髋关节评分，每年对年龄相对相似、以年轻患者为主的队列进行中长期结果评估。第1组中16.4%的患者腹股沟疼痛持续存在，第2组中这一比例为5.5%（P = 0.0159）。第1组中11.5%的患者大腿疼痛持续存在，第2组中这一比例为2.2%（P = 0.0078）。第1组的并发症为4/61，包括2例翻修手术，总生存率为96.7%；而第2组的并发症率为29/182，有15例翻修手术，总生存率为91.8%。第1组没有髋臼内陷病例，但第2组有2例（1%）出现髋臼杯松动或骨溶解。第1组有2例（3.2%）进行了翻修手术。两者均为股骨柄尺寸过小。第2组的15例翻修手术（8.2%）包括股骨柄松动（1例）、不稳定（8例）、感染（3例）、髋臼杯松动（2例）和聚乙烯磨损加速（1例）。与全髋关节置换术相比，半髋关节置换术的大腿和腹股沟疼痛发生率更高，但并发症更少。
