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小梁钛™髋臼组件在髋关节置换术中的临床和影像学结果:至少5年随访结果

Clinical and radiographic outcomes of a trabecular titanium™ acetabular component in hip arthroplasty: results at minimum 5 years follow-up.

作者信息

Perticarini Loris, Zanon Giacomo, Rossi Stefano Marco Paolo, Benazzo Francesco M

机构信息

Clinica Ortopedica e Traumatologica, Università degli Studi di Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy.

出版信息

BMC Musculoskelet Disord. 2015 Dec 3;16:375. doi: 10.1186/s12891-015-0822-9.

Abstract

BACKGROUND

Aim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular Titanium™, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, thus promoting a more physiological load transfer and a more durable fixation.

METHODS

Between September 2007 and November 2009, 134 total hip replacements and eight revisions were carried out using DELTA-TT primary cups (Lima Corporate, Villanova di San Daniele del Friuli, Italy) in 133 consecutive patients. Mean age was 57.5 ± 14.7 SD (18-92) years. Diagnosis was primarily hip osteoarthritis in 85 (63 %) cases, developmental dysplasia of the hip (DDH) in 24 (18 %) and hip avascular necrosis (AVN) in 10 (7 %). All the revision procedures were due to aseptic loosening of the original implant. Approval of the Institutional Review Board of the IRCCS Policlinico San Matteo in Pavia was obtained for this study.

RESULTS

Mean follow-up was 72.7 ± 7.9 SD (60-86) months. Average Harris Hip Score (HHS) significantly increased from 44.2 ± 5.4 SD (35-52) preoperatively to 95.9 ± 3.5 SD (88-100) at the last follow-up. No major post-operative complications were observed. 99.3 % of the acetabular components were radiographically stable at the last follow-up, without any radiolucent lines, sclerotic areas or periprosthetic osteolysis. Kaplan-Meier survival rate was 99.3 % at 5 years (95 % confidence interval).

CONCLUSIONS

This first account on the mid-term clinical performance of the DELTA-TT cup shows primary and secondary stability, thus representing an optimal solution for patients with high demands or affected by severe hip conditions.

摘要

背景

本前瞻性研究的目的是评估使用创新生物材料小梁钛(Trabecular Titanium™)制成的髋臼杯进行全髋关节置换术的中期临床和影像学结果。小梁钛的高孔隙结构和力学性能旨在模仿天然骨,从而促进更符合生理的负荷传递和更持久的固定。

方法

2007年9月至2009年11月期间,连续133例患者使用DELTA-TT初次髋臼杯(利马公司,意大利弗留利-威尼斯朱利亚大区圣丹尼尔-德尔弗留利市维拉诺瓦)进行了134例全髋关节置换术和8例翻修手术。平均年龄为57.5±14.7标准差(18 - 92)岁。诊断主要为髋关节骨关节炎85例(63%),发育性髋关节发育不良(DDH)24例(18%),髋关节缺血性坏死(AVN)10例(7%)。所有翻修手术均因原植入物无菌性松动。本研究获得了帕维亚IRCCS圣马泰奥综合医院机构审查委员会的批准。

结果

平均随访时间为72.7±7.9标准差(60 - 86)个月。平均Harris髋关节评分(HHS)从术前的44.2±5.4标准差(35 - 52)显著提高到最后一次随访时的95.9±3.5标准差(88 - 100)。未观察到重大术后并发症。在最后一次随访时,99.3%的髋臼组件在影像学上稳定,无任何透光线、硬化区域或假体周围骨溶解。5年时的Kaplan-Meier生存率为99.3%(95%置信区间)。

结论

关于DELTA-TT杯中期临床性能的首次报告显示了初次和二次稳定性,因此对于有高要求或受严重髋关节疾病影响的患者而言是一种最佳解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0669/4669605/82abac1314f9/12891_2015_822_Fig1_HTML.jpg

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