莫舍尔压配髋臼组件：18至22年的独立长期评估

The Morscher Press-Fit Acetabular Component: An Independent Long-Term Review at 18-22 Years.

作者信息

Gwynne-Jones David P, Lash Heath W R, James Andrew W, Iosua Ella E, Matheson John A

机构信息

Department of Surgical Sciences, Orthopaedic Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Orthopaedic Surgery, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand.

Department of Orthopaedic Surgery, Dunedin Hospital, Southern District Health Board, Dunedin, New Zealand.

出版信息

J Arthroplasty. 2017 Aug;32(8):2444-2449. doi: 10.1016/j.arth.2017.02.052. Epub 2017 Mar 2.

DOI:10.1016/j.arth.2017.02.052

PMID:28343828

Abstract

BACKGROUND

There are relatively few 20-year results of uncemented acetabular components, and most of these are modular designs. This study reports the 20-year results of a monoblock press-fit acetabular component.

METHODS

A total of 122 total hip arthroplasties (111 patients) using the Morscher cup were reviewed at a mean of 19.7 years. The average age at implantation was 57.3 years (range, 36-74 years), and 81 (66%) were men.

RESULTS

Twenty-two patients (25 hips) had died. Seven hips were revised, including 5 acetabular revisions. Six patients (6 hips) declined to participate but were known not to have been revised. The mean Oxford hip score was 41.1 (range, 22-48), and the mean reduced Western Ontario and McMaster Universities Osteoarthritis Index score was 5.7/48 (range, 0-24). Eccentric wear was seen in 13 (15.7%) and major osteolysis in 14 (17%) of 82 surviving hips with radiographs. The all-cause revision rate was 0.32 per 100 observed component years (95% confidence interval [CI], 0.13-0.66). The 20-year Kaplan-Meier survival was 93.4% (CI, 86.6-96.8) for all-cause revisions, 95.5% (CI, 89.4-98.1) for any acetabular revision, and 97.1% (CI, 91.2-99.1) for acetabular aseptic loosening, wear, or osteolysis.

CONCLUSION

The Morscher acetabular component has continued to perform well at 20 years despite using conventional polyethylene with results that match or surpass other cementless acetabulae.

摘要

背景

非骨水泥髋臼假体20年随访结果相对较少，且大多为模块化设计。本研究报告了整体压配式髋臼假体的20年随访结果。

方法

对122例使用Morscher髋臼杯进行全髋关节置换术的患者（共111例）进行了平均19.7年的随访。植入时的平均年龄为57.3岁（范围36 - 74岁），男性81例（66%）。

结果

22例患者（25髋）死亡。7髋进行了翻修，其中5髋为髋臼翻修。6例患者（6髋）拒绝参与，但已知未进行翻修。牛津髋关节评分平均为41.1（范围22 - 48），简化的西安大略和麦克马斯特大学骨关节炎指数评分平均为5.7/48（范围0 - 24）。82例有影像学资料的存活髋中，13髋（15.7%）出现偏心磨损，14髋（17%）出现严重骨溶解。全因翻修率为每100个观察组件年0.32（95%置信区间[CI]，0.13 - 0.66）。全因翻修的20年Kaplan - Meier生存率为93.4%（CI，86.6 - 96.8），任何髋臼翻修的生存率为95.5%（CI，89.4 - 98.1），髋臼无菌性松动、磨损或骨溶解的生存率为97.1%（CI，91.2 - 99.1）。