Wu Kuan-Ting, Wang Jun-Wen, Lu Yu-Der, Yen Shih-Hsiang, Lee Mel S
1 Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan, Republic of China.
2 College of Medicine, Chang Gung University, Kaohsiung City, Taiwan, Republic of China.
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017721041. doi: 10.1177/2309499017721041.
There has been a debate on the use of ceramic-on-ceramic coupling with the retained femoral stem in isolated acetabular revision. The purpose of this study was to retrospectively review the results and complications of isolated revision of the acetabular component using alumina-on-alumina bearings.
Between August 2010 and December 2013, 22 patients (23 hips) with a mean age of 60.74 years (40-73) underwent isolated revision of the acetabular component from metal-on-polyethylene to alumina-on-alumina bearings without using a metal sleeve on the undamaged trunnion. All patients completed clinical and radiographic evaluation.
At a mean follow-up of 3 years (2-5.5), all patients had a significant improvement in the clinical outcome, including Harris Hip Score (84.9 vs. 43, p < 0.001), West Ontario McMaster University Osteoarthritis Index Score (14.4 vs. 49.2, p < 0.001), and visual analogue pain score (1.42 vs. 6.63, p < 0.001). Complications included one aseptic loosening of the acetabular component and three noisy hips (click only). No fracture of the ceramic bearings, dislocation, infection, or squeaking noise were observed in any of the patients.
Isolated revision of the acetabular component to alumina-on-alumina bearings on the undamaged trunnion may be considered if there is no available titanium sleeves. Our study showed a satisfactory early outcome with minimal complications. However, a longer term follow-up study is necessary.
在单纯髋臼翻修术中使用陶瓷对陶瓷组合并保留股骨柄的问题上一直存在争议。本研究的目的是回顾性分析使用氧化铝对氧化铝轴承进行单纯髋臼部件翻修的结果及并发症。
2010年8月至2013年12月期间，22例患者（23髋）平均年龄60.74岁（40 - 73岁），接受了单纯髋臼部件翻修，从金属对聚乙烯轴承转换为氧化铝对氧化铝轴承，未对未受损的耳轴使用金属套筒。所有患者均完成了临床和影像学评估。
平均随访3年（2 - 5.5年），所有患者的临床结果均有显著改善，包括Harris髋关节评分（84.9对43，p < 0.001）、西安大略和麦克马斯特大学骨关节炎指数评分（14.4对49.2，p < 0.001）以及视觉模拟疼痛评分（1.42对6.63，p < 0.001）。并发症包括1例髋臼部件无菌性松动和3例髋关节有响声（仅为弹响）。未观察到任何患者出现陶瓷轴承骨折、脱位、感染或摩擦音。
如果没有可用的钛套筒，在未受损的耳轴上进行单纯髋臼部件翻修为氧化铝对氧化铝轴承的翻修术是可以考虑的。我们的研究显示早期结果令人满意，并发症最少。然而，有必要进行长期随访研究。
