Higuchi Yoshitoshi, Hasegawa Yukiharu, Komatsu Daigo, Seki Taisuke, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Hip and Knee Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Arthroplasty. 2017 Jan;32(1):155-160. doi: 10.1016/j.arth.2016.06.014. Epub 2016 Jun 23.
The aim of the study was to compare the clinical and radiographic results of consecutive ceramic-on-ceramic bearings with and without a metal-backed titanium sleeve in patients undergoing total hip arthroplasty.
Eighty-five patients (64 women and 21 men; average age 55.2 years) were included in the A group without sleeve while 147 patients (116 women and 31 men; average age 54.2 years) were included in the B group with sleeve. Clinical and radiologic measurements at follow-up (range, 5-14 years; average, 8.1 years) were analyzed.
The mean latest postoperative Harris Hip Score was 89.1 for patients from both groups. One joint (1.2%) in the A group displayed ceramic liner fracture, while no incidences of liner fracture occurred in the B group. Audible squeaking was observed in 1 joint (1.2%) in the A group and 1 (0.7%) in the B group. The mean annual liner rate of wear was 0.0049 and 0.0046 mm/y for the A group and B group, respectively. Three joints in the A group (3.5%) required revision total hip arthroplasty because of individual episodes of aseptic cup loosening, ceramic liner fracture, and infection. One joint in the B group (0.7%) required revision because of progressive osteolysis of the proximal femur. Ten-year Kaplan-Meier survivorship, based on an end point of component loosening and bearing failure, was 97.6% for the A group and 99.3% for the B group.
There were no clinical, radiographic, or survivorship differences between groups.
本研究旨在比较在接受全髋关节置换术的患者中，连续使用带金属背衬钛套筒和不带金属背衬钛套筒的陶瓷对陶瓷关节轴承的临床和影像学结果。
A组纳入85例患者（64例女性和21例男性；平均年龄55.2岁），未使用套筒；B组纳入147例患者（116例女性和31例男性；平均年龄54.2岁），使用套筒。对随访时（范围5 - 14年；平均8.1年）的临床和放射学测量结果进行分析。
两组患者术后最新的平均Harris髋关节评分均为89.1。A组有1个关节（1.2%）出现陶瓷内衬骨折，而B组未发生内衬骨折事件。A组有1个关节（1.2%）和B组有1个关节（0.7%）观察到可闻及的吱吱声。A组和B组内衬的年均磨损率分别为0.0049和0.0046 mm/年。A组有3个关节（3.5%）因无菌性髋臼松动、陶瓷内衬骨折和感染等个别情况需要进行翻修全髋关节置换术。B组有1个关节（0.7%）因股骨近端进行性骨溶解需要翻修。基于假体松动和轴承失效的终点，A组的10年Kaplan - Meier生存率为97.6%，B组为99.3%。
两组之间在临床、影像学或生存率方面无差异。
