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髋关节表面置换术:美国单中心大型病例系列研究

Hip resurfacing: a large, US single-surgeon series.

作者信息

Brooks P J

机构信息

Cleveland Clinic, 9500 Euclid Ave, A-41, Cleveland, Ohio, 44195, USA.

出版信息

Bone Joint J. 2016 Jan;98-B(1 Suppl A):10-3. doi: 10.1302/0301-620X.98B1.36360.

Abstract

Hip resurfacing has been proposed as an alternative to traditional total hip arthroplasty in young, active patients. Much has been learned following the introduction of metal-on-metal resurfacing devices in the 1990s. The triad of a well-designed device, implanted accurately, in the correct patient has never been more critical than with these implants. Following Food and Drug Administration approval in 2006, we studied the safety and effectiveness of one hip resurfacing device (Birmingham Hip Resurfacing) at our hospital in a large, single-surgeon series. We report our early to mid-term results in 1333 cases followed for a mean of 4.3 years (2 to 5.7) using a prospective, observational registry. The mean patient age was 53.1 years (12 to 84); 70% were male and 91% had osteoarthritis. Complications were few, including no dislocations, no femoral component loosening, two femoral neck fractures (0.15%), one socket loosening (0.08%), three deep infections (0.23%), and three cases of metallosis (0.23%). There were no destructive pseudotumours. Overall survivorship at up to 5.7 years was 99.2%. Aseptic survivorship in males under the age of 50 was 100%. We believe this is the largest United States series of a single surgeon using a single resurfacing system.

摘要

对于年轻、活跃的患者,髋关节表面置换术已被提议作为传统全髋关节置换术的替代方案。自20世纪90年代金属对金属表面置换装置引入以来,人们已经学到了很多东西。对于这些植入物而言,精心设计的装置、精确植入以及选择合适的患者这三个要素从未像现在这样至关重要。2006年获得美国食品药品监督管理局批准后,我们在我院对一种髋关节表面置换装置(伯明翰髋关节表面置换术)进行了安全性和有效性研究,该研究纳入了由单一外科医生主刀的大量病例。我们使用前瞻性观察登记系统报告了1333例患者的早期至中期结果,这些患者平均随访了4.3年(2至5.7年)。患者平均年龄为53.1岁(12至84岁);70%为男性,91%患有骨关节炎。并发症很少,包括无脱位、无股骨部件松动、两例股骨颈骨折(0.15%)、一例髋臼杯松动(0.08%)、三例深部感染(0.23%)以及三例金属沉着病(0.23%)。无破坏性假肿瘤。至5.7年时的总体生存率为99.2%。50岁以下男性的无菌性生存率为100%。我们认为这是美国单一外科医生使用单一表面置换系统的最大系列病例。

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