Ledford Cameron K, Vap Alexander R, Bolognesi Michael P, Wellman Samuel S
Duke University Medical Center, Department of Orthopaedic Surgery, Durham, North Carolina.
J Surg Orthop Adv. 2015 Summer;24(2):99-104. doi: 10.3113/jsoa.2015.0099.
Concerns remain about total hip arthroplasty (THA) performed in very young patients, especially those with complex medical history such as allogeneic bone marrow transplantation (ABMT). This study retrospectively reviews the perioperative courses and functional outcomes of ABMT patients <21 years old undergoing primary uncemented THA. Nine THAs were performed in five ABMT patients at an average age of 19.7 years. The interval between ABMT and THA was 73.0 months with clinical follow-up of 25.8 months. Harris Hip Scores (HHS) increased dramatically from preoperatively 44.5 (range, 31.1-53.4) to postoperatively 85.2 (range, 72.0-96.0) and all patients subjectively reported a good (four hips) to excellent (five hips) overall outcome. There was one reoperation for periprosthetic fracture fixation but there were no infections or revisions performed. Despite the history of severe hematopoietic conditions requiring ABMT, these very young patients do appear to have improved pain and function following primary THA with short-term follow-up.
对于非常年轻的患者，尤其是那些有复杂病史（如异基因骨髓移植（ABMT））的患者进行全髋关节置换术（THA），仍存在担忧。本研究回顾性分析了年龄小于21岁的接受初次非骨水泥THA的ABMT患者的围手术期过程和功能结果。5例ABMT患者共进行了9次THA，平均年龄为19.7岁。ABMT与THA之间的间隔时间为73.0个月，临床随访时间为25.8个月。Harris髋关节评分（HHS）从术前的44.5（范围31.1 - 53.4）显著提高到术后的85.2（范围72.0 - 96.0），所有患者主观报告总体结果为良好（4髋）至优秀（5髋）。有1例因假体周围骨折固定进行了再次手术，但未发生感染或翻修手术。尽管有需要ABMT的严重造血疾病史，但这些非常年轻的患者在初次THA后的短期随访中，疼痛和功能确实有所改善。
