Salo P P, Honkanen P B, Ivanova I, Reito A, Pajamäki J, Eskelinen A
Tampere University Hospital, School of Medicine, 33014 Tampere, Finland.
Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
Bone Joint J. 2017 Jan;99-B(1):44-50. doi: 10.1302/0301-620X.99B1.37612.
We evaluated the short-term functional outcome and prevalence of bearing-specific generation of audible noise in 301 patients (336 hips) operated on with fourth generation (Delta) medium diameter head, ceramic-on-ceramic (CoC) total hip arthroplasties (THAs).
There were 191 female (63%) and 110 male patients (37%) with a mean age of 61 years (29 to 78) and mean follow-up of 2.1 years (1.3 to 3.4). Patients completed three questionnaires: Oxford Hip Score (OHS), Research and Development 36-item health survey (RAND-36) and a noise-specific symptom questionnaire. Plain radiographs were also analysed. A total of three hips (0.9%) were revised.
There were 52 patients (54 hips, 17%) who reported noise, and in 25 (48%) of them the noise was frequently heard. In the multiple regression analysis, the only independent risk factor for noise was a specific THA brand, with a threefold increased risk (95% confidence intervals 1.39 to 6.45, p = 0.005) of noise compared with the reference THA brand. Patients with noisy hips had lower median OHS (43 versus 46.5, p = 0.002) and their physical functioning (p = 0.021) subscale in RAND-36 was reduced.
Noise was surprisingly common in this population. Cite this article: Bone Joint J 2017;99-B:44-50.
我们评估了301例（336髋）接受第四代（Delta）中直径股骨头陶瓷对陶瓷全髋关节置换术（THA）患者的短期功能结局以及特定负重时可闻性噪声的发生率。
患者中女性191例（63%），男性110例（37%），平均年龄61岁（29至78岁），平均随访2.1年（1.3至3.4年）。患者完成了三份问卷：牛津髋关节评分（OHS）、36项研发健康调查（RAND - 36）以及一份特定噪声症状问卷。还对骨盆前后位X线片进行了分析。共有3髋（0.9%）进行了翻修。
52例患者（54髋，17%）报告有噪声，其中25例（48%）经常听到噪声。在多元回归分析中，噪声的唯一独立危险因素是特定的THA品牌，与对照THA品牌相比，出现噪声的风险增加了两倍（95%置信区间1.39至6.45，p = 0.005）。有噪声髋关节的患者OHS中位数较低（43对46.5，p = 0.002），且其RAND - 36中的身体功能子量表得分降低（p = 0.021）。
在该人群中，噪声现象出奇地常见。引用本文：《骨与关节杂志》2017年；99 - B：44 - 50。
