Moroni Antonio, Miscione Maria Teresa, Orsini Riccardo, Micera Giovanni, Mosca Salvatore, Sinapi Fabrizio, De Girolamo Laura, Banfi Giuseppe
Vita-Salute San Raffaele University, Milan - Italy.
IRCCS (Institutes for Research, Hospitalisation and Health Care) Galeazzi, Milan - Italy.
Hip Int. 2017 Mar 31;27(2):134-139. doi: 10.5301/hipint.5000424. Epub 2017 Mar 21.
Metal-on-metal hip resurfacing (MoMHR) has been proposed as an effective surgical treatment for young and active patients with symptomatic hip disease. Recently, good clinical and radiographic outcomes have been reported by the designer surgeons at a 15.3 years follow-up; however, results at long follow-up by non-designer surgeons are less satisfactory. The aim of the study was to investigate if MoMHR can produce satisfactory clinical and radiographic results and if survival rate can be high even if the procedure is performed by non-designer surgeons.
All patients were assessed about implant survival. All patients completed an Oxford Hip Score (OHS), Harris Hip Score (HHS) and a University of California Los Angeles (UCLA) activity score preoperatively, at 1 year and at last available follow-up; at this time, a standard anteroposterior weight-bearing radiograph was performed.
The survival rate with revision for any reason is 96%, similar to those obtained by designer surgeons. All the clinical scores improved over time: according to the OHS the survivors are asymptomatic and according to the UCLA maintain a high level of function. 6 remodellings of the femoral neck and 2 heterotopic bone formations were seen, but they were asymptomatic.
As designer surgeons have already shown, MoMHR can provide in active patients a durable treatment for hip arthritis, with low risk of revision and good results at 10 years follow-up, even if the procedure is performed by non-designer surgeons.
金属对金属髋关节表面置换术(MoMHR)已被提议作为治疗有症状髋关节疾病的年轻活跃患者的一种有效手术方法。最近,在15.3年的随访中,设计该手术的外科医生报告了良好的临床和影像学结果;然而,非设计该手术的外科医生进行长期随访的结果则不太令人满意。本研究的目的是调查MoMHR是否能产生令人满意的临床和影像学结果,以及即使该手术由非设计该手术的外科医生进行,其生存率是否能很高。
对所有患者的植入物存活情况进行评估。所有患者在术前、术后1年及最后一次随访时均完成了牛津髋关节评分(OHS)、哈里斯髋关节评分(HHS)和加利福尼亚大学洛杉矶分校(UCLA)活动评分;此时,拍摄标准的前后位负重X线片。
因任何原因进行翻修的生存率为96%,与设计该手术的外科医生所获得的生存率相似。所有临床评分均随时间改善:根据OHS评分,存活患者无症状,根据UCLA评分,患者保持较高的功能水平。观察到6例股骨颈重塑和2例异位骨形成,但均无症状。
正如设计该手术的外科医生已经表明的那样,MoMHR可为活跃患者提供一种持久的髋关节炎治疗方法,翻修风险低,在10年随访时效果良好,即使该手术由非设计该手术的外科医生进行。