Kawamura Haruo, Mishima Hajime, Sugaya Hisashi, Nishino Tomofumi, Shimizu Yukiyo, Miyakawa Shumpei
Department of Orthopaedic Surgery, Tsukuba University Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
J Orthop Sci. 2016 May;21(3):342-7. doi: 10.1016/j.jos.2016.02.004. Epub 2016 Mar 9.
The Harris-Galante total hip arthroplasty (THA) is a first-generation cementless THA with a porous coating for biological fixation of the implant. Many studies report excellent long-term results for the acetabular cup, but few long-term studies exist for the femoral stem because of relatively poor short-term and midterm results. Here we present the 21- to 27-year results of the cup and the stem of the Harris-Galante THA.
From 1985 to 1991, 102 Harris-Galante THAs were inserted in 82 patients. At the time of the THA, the mean patient age was 54 years (range, 20-78 years). The primary diagnosis was secondary osteoarthritis due to developmental hip dysplasia (69 [68%] hips). The Japanese Orthopaedic Association (JOA) hip score and thigh pain were measures of clinical outcome. Radiographic review was performed retrospectively. Implant survival was evaluated by Kaplan-Meier analysis.
Of 102 hips, 35 hips were from 31 deceased patients, 5 patients (6 hips) were lost to follow-up, 12 hips were revised, and 49 hips were from patients living at the latest follow-up. Among the living patients, 36 hips had a clinical evaluation and 42 hips had a radiograph obtained more than 21 years. The JOA hip score improved from 42 points preoperatively to 83.5 points at the latest follow-up. Thigh pain was reported in 13 hips. One cup and four stems were loose at the latest radiographic review. Most cup revisions were related to acetabular osteolysis. Fifteen hips showed severe stress shielding. Kaplan-Meier analysis of survivorship with any revision, acetabular reoperation, stem revision, and stem loosening as the end point was 87.0%, 90.3%, 95.7% and 86.4%, respectively, at 24.6 years.
Long-term implant survival and clinical results of the Harris-Galante THA were good. Acetabular osteolysis-related cup loosening was a problem of the cup. Loosening, thigh pain, and stress shielding were problems of the stem.
哈里斯-加兰特全髋关节置换术（THA）是第一代非骨水泥型THA，其髋臼杯具有多孔涂层，用于植入物的生物学固定。许多研究报告了髋臼杯出色的长期效果，但由于股骨柄的短期和中期效果相对较差，针对股骨柄的长期研究较少。在此，我们展示了哈里斯-加兰特THA髋臼杯和股骨柄21至27年的随访结果。
1985年至1991年，82例患者接受了102次哈里斯-加兰特THA手术。THA手术时，患者平均年龄为54岁（范围20至78岁）。主要诊断为发育性髋关节发育不良继发的骨关节炎（69髋[68%]）。日本骨科学会（JOA）髋关节评分和大腿疼痛情况作为临床结果的衡量指标。对影像学资料进行回顾性分析。采用Kaplan-Meier分析评估植入物生存率。
102髋中，35髋来自31例已故患者，5例患者（6髋）失访，12髋进行了翻修，49髋来自最新随访时仍在世的患者。在世患者中，36髋接受了临床评估，42髋获得了超过21年的影像学资料。JOA髋关节评分从术前的42分提高到最新随访时的83.5分。13髋报告有大腿疼痛。在最新的影像学检查中，1个髋臼杯和4个股骨柄出现松动。大多数髋臼杯翻修与髋臼骨溶解有关。15髋出现严重的应力遮挡。以任何翻修、髋臼再次手术、股骨柄翻修和股骨柄松动为终点的Kaplan-Meier生存率分析显示，在24.6年时分别为87.0%、90.3%、95.7%和86.4%。
哈里斯-加兰特THA的长期植入物生存率和临床结果良好。髋臼骨溶解相关的髋臼杯松动是髋臼杯的问题。松动、大腿疼痛和应力遮挡是股骨柄的问题。
