Wang Tao, Sun Jun-Ying, Zhao Xi-Jiang, Liu Yong, Yin Hai-Bo
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China; Department of Orthopedic Surgery, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China.
Arthroplast Today. 2016 Aug 25;2(4):205-209. doi: 10.1016/j.artd.2016.04.004. eCollection 2016 Dec.
The results of ceramic-on-ceramic (CoC) total hip arthroplasty (THA) in younger patients were not univocal. This study aims to evaluate the results of CoC bearing THA in patients younger than 50 years.
A total of 90 younger patients performed CoC THAs during March 2003 and May 2008 were included in this study. Hip function and activity were evaluated with Harris hip score and University of California Los Angeles activity score. We had discussed survival rates, radiological findings of component loosening or osteolysis, and ceramic-related complications in these patients.
The mean Harris hip score increased from 46.3 ± 12.0 points (range, 28-70 points) before surgery to 92.5 ± 5.6 points (range, 78-100 points) at the final follow-up. The mean preoperative University of California Los Angeles activity score was 4.2 ± 1.1 points (range, 2-6 points), which improved to a mean of 7.2 ± 1.3 points (range, 4-10 points). At the time of the last follow-up, there was found to be 1 occurrence of hip dislocation, 1 squeaking, and 2 "sandwich" ceramic liners fractured during normal activity of daily living. No hips showed osteolysis or required revision for aseptic loosening. Kaplan-Meier survivorship with revision due to loosening or osteolysis was 100% and with revision due to ceramic fracture was 97.3% (95% confidence interval, 93.7%-100%) at a mean of 9.4 years.
This study with the use of CoC bearings THAs in younger patients have shown promising results and higher rate of survivorship without evidence of osteolysis.
在年轻患者中，陶瓷对陶瓷（CoC）全髋关节置换术（THA）的结果并不明确。本研究旨在评估50岁以下患者采用CoC关节置换的THA结果。
本研究纳入了2003年3月至2008年5月期间进行CoC THA手术的90例年轻患者。采用Harris髋关节评分和加州大学洛杉矶分校活动评分评估髋关节功能和活动情况。我们讨论了这些患者的生存率、假体松动或骨溶解的影像学表现以及与陶瓷相关的并发症。
Harris髋关节评分的平均值从术前的46.3±12.0分（范围28 - 70分）提高到末次随访时的92.5±5.6分（范围78 - 100分）。术前加州大学洛杉矶分校活动评分的平均值为4.2±1.1分（范围2 - 6分），改善后平均值为7.2±1.3分（范围4 - 10分）。在末次随访时，发现有1例髋关节脱位、1例出现摩擦音，以及2例“三明治”陶瓷内衬在日常生活正常活动中发生骨折。没有髋关节出现骨溶解或因无菌性松动而需要翻修。因松动或骨溶解进行翻修的Kaplan-Meier生存率为100%，因陶瓷骨折进行翻修的生存率为97.3%（95%置信区间，93.7% - 100%），平均随访时间为9.4年。
本研究表明，在年轻患者中使用CoC关节置换的THA取得了令人满意的结果，生存率较高，且无骨溶解迹象。
