Halawi Mohamad J, Brigati David, Messner William, Brooks Peter J
Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
J Arthroplasty. 2017 Jun;32(6):1880-1883. doi: 10.1016/j.arth.2016.12.044. Epub 2017 Jan 3.
Birmingham hip resurfacing (BHR) is the only Food and Drug Administration-approved hip resurfacing system available in the United States and is used as an alternative to conventional total hip arthroplasty in younger patients. The purpose of this study is to report on the midterm outcomes of BHR in patients 55 years and younger, and specifically to examine the risk factors for aseptic failure, all-cause revision, and complications in this patient population.
Four hundred forty-two consecutive patients with 5-year follow-up were retrospectively reviewed. Multivariate analyses were conducted to control for potential confounding factors identified by univariate analyses.
Mean follow-up was 71.68 ± 10.24 months. Among the potential risk factors, only female gender and smaller head sizes had a significant univariate relationship with aseptic revision, all-cause revision, and all-cause complications. When both risk factors were included in a multivariable logistic regression model, analyses showed both variables were closely related, with female gender a better predictor of adverse outcomes than head size (ie, small head size can be thought of as a proxy for female gender). The 5-year implant survival is 95.1% females compared to 99.0% in males.
Hip resurfacing with BHR has excellent survival rates in young patients with degenerative hip disease. Although this study suggests that females with small templated head sizes may not be suitable candidates for BHR, further studies are needed to better understand the underlying differences in gender.
伯明翰髋关节表面置换术（BHR）是美国食品药品监督管理局批准的唯一可用的髋关节表面置换系统，在年轻患者中用作传统全髋关节置换术的替代方法。本研究的目的是报告55岁及以下患者BHR的中期结果，特别是检查该患者群体中无菌性失败、全因翻修和并发症的危险因素。
回顾性分析442例连续随访5年的患者。进行多变量分析以控制单变量分析确定的潜在混杂因素。
平均随访时间为71.68±10.24个月。在潜在危险因素中，只有女性性别和较小的股骨头尺寸与无菌性翻修、全因翻修和全因并发症有显著的单变量关系。当两个危险因素都纳入多变量逻辑回归模型时，分析表明这两个变量密切相关，女性性别比股骨头尺寸更能预测不良结局（即，小股骨头尺寸可被视为女性性别的替代指标）。5年植入物生存率女性为95.1%，男性为99.0%。
对于患有退行性髋关节疾病的年轻患者，采用BHR进行髋关节表面置换术具有优异的生存率。虽然本研究表明模板化股骨头尺寸小的女性可能不是BHR的合适候选人，但需要进一步研究以更好地了解性别方面的潜在差异。
