Hoberg Maik, Konrads Christian, Engelien Jana, Oschmann Dorothee, Holder Michael, Walcher Matthias, Rudert Maximilian
Orthopaedic Clinic Koenig-Ludwig-Haus, Center for Musculoskeletal Research, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Wuerzburg, Germany,
Int Orthop. 2015 Sep;39(9):1709-13. doi: 10.1007/s00264-015-2699-5. Epub 2015 Feb 18.
Revision hip arthroplasty using a modular tapered design gives the possibility for customising the prostheses to the individual anatomy intra-operatively. The success of this kind of surgery is still controversial due to the relative lack of medium- to long-term follow-up. Therefore we analysed the clinical and radiological outcome of the modular MRP-TITAN stem with diaphyseal fixation in revision hip surgery.
In this retrospective study we included 136 consecutive patients with MRP-TITAN stem implanted during revision hip arthroplasty. The average follow-up was 55 months. For clinical evaluation we used the Harris Hip Score and the Merle d'Aubigné and Postel score. The health-related quality of life was determined with the visual analogue pain scale.
The surgeries were performed 109 months after primary total hip arthroplasty on average. The main indications for the MRP-TITAN revision stem were aseptic loosening, infection, and periprosthetic fracture. In the clinical outcome, patients achieved 75.1 points in the Harris Hip Score and 14.4 points in the Merle d'Aubigné and Postel Score. Mean level of persisting pain was 0.7 (VAS). The overall survival of the MRP stem in revision hip arthroplasty revealed 85.6% survival at 9.75 years' follow-up with a repeat revision rate of 6.8%.
Performing revision hip arthroplasty using the MRP-TITAN stem revealed a good clinical outcome. There is a tendency for better results in comparison with the information given in literature for cementless modular revision stems including a lower rate in re-revisions.
采用模块化锥形设计的翻修髋关节置换术能够在术中根据个体解剖结构定制假体。由于相对缺乏中长期随访，这类手术的成功率仍存在争议。因此，我们分析了在翻修髋关节手术中采用骨干固定的模块化MRP-TITAN柄的临床和影像学结果。
在这项回顾性研究中，我们纳入了136例在翻修髋关节置换术中植入MRP-TITAN柄的连续患者。平均随访时间为55个月。临床评估采用Harris髋关节评分以及Merle d'Aubigné和Postel评分。通过视觉模拟疼痛量表确定与健康相关的生活质量。
手术平均在初次全髋关节置换术后109个月进行。MRP-TITAN翻修柄的主要适应证为无菌性松动、感染和假体周围骨折。在临床结果方面，患者的Harris髋关节评分为75.1分，Merle d'Aubigné和Postel评分为14.4分。持续疼痛的平均水平为0.7（视觉模拟疼痛量表）。在翻修髋关节置换术中，MRP柄的总体生存率在9.75年的随访中显示为85.6%，再次翻修率为6.8%。
使用MRP-TITAN柄进行翻修髋关节置换术显示出良好的临床结果。与文献中给出的关于非骨水泥模块化翻修柄的信息相比，有取得更好结果的趋势，包括再次翻修率较低。
