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年轻创伤后髋关节炎患者的全髋关节置换术

Total hip arthroplasty in young patients with post-traumatic arthritis of the hip.

作者信息

Swarup Ishaan, Sutherland Ryan, Burket Jayme C, Figgie Mark P

机构信息

Department of Orthopaedic Surgery, Hospital for Special Surgery, New York - USA.

Healthcare Research Institute, Hospital for Special Surgery, New York - USA.

出版信息

Hip Int. 2017 Nov 21;27(6):546-550. doi: 10.5301/hipint.5000499. Epub 2017 May 23.

Abstract

BACKGROUND

Post-traumatic arthritis of the hip is a degenerative condition that commonly affects young patients. In this study, we evaluate long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients aged 35 or younger with post-traumatic arthritis of the hip.

METHODS

We conducted a retrospective study with follow-up. A chart review was performed to identify young patients with post-traumatic arthritis of the hip treated with primary THA. Follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Implant survival was assessed using Kaplan-Meier survival analysis, and patient outcomes were determined using the hip disability and osteoarthritis outcome score (HOOS).

RESULTS

We studied 42 patients (44 THAs) with a mean time to follow-up of 14 years. The 10-year implant survival rate was 87% and 20-year implant survival rate was 41%. Implant survival did not differ based on patient age, gender, implant type, bearing surface, or use of cement for implant fixation (p>0.05). The mean HOOS scores at follow-up were 87 for pain, 85 for symptoms, 89 for ADLs, and 76 for sports. HOOS scores were significantly worse in patients that had undergone revision THA (p<0.05).

CONCLUSIONS

Young patients with post-traumatic arthritis of the hip have good long-term outcomes after THA. However, revision THA is predictive of worse long-term outcomes.

摘要

背景

创伤后髋关节炎是一种常见于年轻患者的退行性疾病。在本研究中,我们评估了35岁及以下创伤后髋关节炎患者初次全髋关节置换术(THA)后的长期植入物生存率和患者报告的结局。

方法

我们进行了一项有随访的回顾性研究。通过查阅病历确定接受初次THA治疗的年轻创伤后髋关节炎患者。进行随访调查以确定植入物生存率和患者报告的结局。使用Kaplan-Meier生存分析评估植入物生存率,使用髋关节残疾和骨关节炎结局评分(HOOS)确定患者结局。

结果

我们研究了42例患者(44次THA),平均随访时间为14年。10年植入物生存率为87%,20年植入物生存率为41%。植入物生存率在患者年龄、性别、植入物类型、关节面或植入物固定是否使用骨水泥方面无差异(p>0.05)。随访时HOOS平均评分疼痛为87分,症状为85分,日常生活活动为89分,运动为76分。接受翻修THA的患者HOOS评分明显更差(p<0.05)。

结论

年轻的创伤后髋关节炎患者THA术后长期结局良好。然而,翻修THA预示着更差的长期结局。

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