De Martino I, De Santis V, D'Apolito R, Sculco P K, Cross M B, Gasparini G
Hospital for Special Surgery, Complex Joint Reconstruction Center, Department of Orthopaedic Surgery, 535 East 70th Street, New York, NY, 10021, USA.
Catholic University of the Sacred Heart, Agostino Gemelli University Hospital, Orthopaedic Surgery Division, Department of Geriatrics, Neurosciences and Orthopaedics, Largo Agostino Gemelli 8, Rome, 00168, Italy.
Bone Joint J. 2017 Jan;99-B(1):29-36. doi: 10.1302/0301-620X.99B1.BJJ-2016-0231.R1.
We report on the outcome of the Synergy cementless femoral stem with a minimum follow-up of 15 years (15 to 17).
A retrospective review was undertaken of a consecutive series of 112 routine primary cementless total hip arthroplasties (THAs) in 102 patients (112 hips). There were 60 female and 42 male patients with a mean age of 61 years (18 to 82) at the time of surgery. A total of 78 hips in the 69 patients remain in situ; nine hips in eight patients died before 15 years, and 16 hips in 16 patients were revised. Clinical outcome scores and radiographs were available for 94 hips in 85 patients.
In all, four stems were revised. One stem was revised for aseptic loosening; two stems because of deep infection; and one because of periprosthetic femoral fracture. There was a significant improvement in all components of the Western Ontario and McMaster Universities Osteoarthritis Index score at the final follow-up (total: p < 0.001, pain: p < 0.001, stiffness: p < 0.001, function: p < 0.001). The mean Harris Hip Scores improved from 47 points (27 to 59) pre-operatively to 89 points (65 to 100) at the latest follow-up (p < 0.001). Kaplan-Meier survivorship, with stem revision for aseptic loosening as the endpoint, was 98.9% at 15 years (95% confidence interval (CI) 96.9 to 100, number at risk at 15 years: 90) and with stem revision for any reason was 95.7% (95% CI 91.7 to 99.8, number at risk at 15 years: 90).
The Synergy cementless femoral stem demonstrates excellent survivorship and functional outcomes at 15 years. Cite this article: Bone Joint J 2017;99-B:29-36.
我们报告了Synergy无骨水泥股骨柄假体至少15年（15至17年）的随访结果。
回顾性分析了102例患者（112髋）连续进行的112例常规初次无骨水泥全髋关节置换术（THA）。手术时，有60例女性和42例男性患者，平均年龄61岁（18至82岁）。69例患者中的78髋仍在位；8例患者中的9髋在15年前死亡，16例患者中的16髋进行了翻修。85例患者中的94髋有临床结果评分和X线片资料。
总共4个股骨柄进行了翻修。1个股骨柄因无菌性松动进行翻修；2个股骨柄因深部感染进行翻修；1个股骨柄因假体周围股骨骨折进行翻修。在末次随访时，西安大略和麦克马斯特大学骨关节炎指数评分的所有项目均有显著改善（总分：p<0.001，疼痛：p<0.001，僵硬：p<0.001，功能：p<0.001）。Harris髋关节平均评分从术前的47分（27至59分）提高到最近随访时的89分（65至100分）（p<0.001）。以无菌性松动导致的股骨柄翻修为终点的Kaplan-Meier生存率在15年时为98.9%（95%置信区间（CI）96.9至100，15年时风险例数：90），以任何原因导致的股骨柄翻修为终点的生存率为95.7%（95%CI 91.7至99.8，15年时风险例数：90）。
Synergy无骨水泥股骨柄在15年时显示出优异的生存率和功能结果。引用本文：《骨与关节杂志》2017；99-B：29-36。
