Lim Seung-Jae, Kim Sang-Min, Kim Dong-Wook, Moon Young-Wan, Park Youn-Soo
Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul - Korea.
Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon - Korea.
Hip Int. 2016 Mar-Apr;26(2):144-8. doi: 10.5301/hipint.5000311. Epub 2016 Feb 5.
The purpose of this study was to evaluate the results of cementless total hip arthroplasty (THA) using a 32 mm or larger Biolox®delta ceramic-on-ceramic (CoC) bearing in patients with osteonecrosis of the femoral head after a minimum of 5 years of follow-up.
We retrospectively analysed 44 patients (53 hips) who underwent cementless THA using Biolox®delta CoC bearing. There were 33 men (40 hips) and 11 women (13 hips) with the mean age of 49 years. A 36 mm head was used in 42 (79%) of 53 hips and a 32 mm head was used in 11 hips with smaller acetabular shells. The mean duration of follow-up was 5.3 years (range 5-6 years).
The mean Harris Hip Score improved from 50 points preoperatively to 97 points at final follow-up (p<0.001). All acetabular and femoral components showed radiographic evidence of osseointegration. No osteolysis was observed. No patients sustained ceramic fracture. An audible hip noise was identified in 2 (4%) of the 53 hips (1 squeaking and 1 clicking). Survivorship with revision for any reason at a minimum of 5 years was 100% in the best-case scenario and 95 % in the worst-case scenario.
The minimum 5-year results of cementless THA using a 32 mm or larger Biolox®delta CoC bearing in patients with osteonecrosis of the femoral head were encouraging with excellent survivorship. However, it was also found that the risk of noise development remains even for the new alumina matrix composite ceramic.
本研究的目的是评估在至少5年的随访后，使用32毫米或更大尺寸的Biolox®delta陶瓷对陶瓷（CoC）轴承进行非骨水泥型全髋关节置换术（THA）治疗股骨头坏死患者的结果。
我们回顾性分析了44例（53髋）接受使用Biolox®delta CoC轴承的非骨水泥型THA的患者。其中男性33例（40髋），女性11例（13髋），平均年龄49岁。53髋中的42髋（79%）使用了36毫米的股骨头，11髋较小的髋臼杯使用了32毫米的股骨头。平均随访时间为5.3年（范围5 - 6年）。
Harris髋关节评分均值从术前的50分提高到末次随访时的97分（p<0.001）。所有髋臼和股骨组件均显示出骨整合的影像学证据。未观察到骨溶解。没有患者发生陶瓷骨折。53髋中有2髋（4%）出现可闻及的髋关节响声（1例嘎吱声和1例咔嗒声）。在最佳情况下，至少5年因任何原因翻修的生存率为100%，在最坏情况下为95%。
对于股骨头坏死患者，使用32毫米或更大尺寸的Biolox®delta CoC轴承进行非骨水泥型THA的至少5年结果令人鼓舞，生存率极佳。然而，研究还发现，即使是新型氧化铝基复合陶瓷，也仍存在产生响声的风险。
