Tokarski A T, Novack T A, Parvizi J
The Rothman Institute, 925 Chestnut Street, Philadelphia, 19107, USA.
Bone Joint J. 2015 Jan;97-B(1):45-9. doi: 10.1302/0301-620X.97B1.34236.
We hypothesised that the use of tantalum (Ta) acetabular components in revision total hip arthroplasty (THA) was protective against subsequent failure due to infection. We identified 966 patients (421 men, 545 women and 990 hips) who had undergone revision THA between 2000 and 2013. The mean follow up was 40.2 months (3 months to 13.1 years). The mean age of the men and women was 62.3 years (31 to 90) and 65.1 years (25 to 92), respectively. Titanium (Ti) acetabular components were used in 536 hips while Ta components were used in 454 hips. In total, 73 (7.3%) hips experienced subsequent acetabular failure. The incidence of failure was lower in the Ta group at 4.4% (20/454) compared with 9.9% (53/536) in the Ti group (p < 0.001, odds ratio 2.38; 95% CI 1.37 to 4.27). Among the 144 hips (64 Ta, 80 Ti) for which revision had been performed because of infection, failure due to a subsequent infection was lower in the Ta group at 3.1% (2/64) compared with 17.5% (14/80) for the Ti group (p = 0.006). Thus, the use of Ta acetabular components during revision THA was associated with a lower incidence of failure from all causes and Ta components were associated with a lower incidence of subsequent infection when used in patients with periprosthetic joint infection.
我们假设，在翻修全髋关节置换术（THA）中使用钽（Ta）髋臼组件可预防因感染导致的后续失败。我们确定了966例在2000年至2013年间接受翻修THA的患者（421名男性、545名女性和990个髋关节）。平均随访时间为40.2个月（3个月至13.1年）。男性和女性的平均年龄分别为62.3岁（31至90岁）和65.1岁（25至92岁）。536个髋关节使用了钛（Ti）髋臼组件，而454个髋关节使用了Ta组件。总共有73个（7.3%）髋关节出现了后续髋臼失败。Ta组的失败发生率较低，为4.4%（20/454），而Ti组为9.9%（53/536）（p<0.001，优势比2.38；95%可信区间1.37至4.27）。在因感染而进行翻修的144个髋关节中（64个Ta，80个Ti），Ta组因后续感染导致的失败率较低，为3.1%（2/64），而Ti组为17.5%（14/80）（p = 0.006）。因此，在翻修THA期间使用Ta髋臼组件与所有原因导致的失败发生率较低相关，并且当用于假体周围关节感染患者时，Ta组件与后续感染的发生率较低相关。
