Slaven Sean E, Purcell Richard L, Mack Andrew W, Bedard Nicholas A, Warth Lucian C, Callaghan John J
1Walter Reed National Military Medical Center, Bethesda, Maryland 2University of Iowa, Iowa City, Iowa 3Indiana University School of Medicine, Indianapolis, Indiana.
J Bone Joint Surg Am. 2017 Oct 4;99(19):1647-1653. doi: 10.2106/JBJS.16.01420.
The purpose of this study was to update the results of a prospective series of 100 primary cementless total hip arthroplasty (THA) procedures that were performed between 1983 and 1986 with use of the Porous Coated Anatomic (PCA) system. This is one of the first prospective studies of cementless primary THA with a minimum of 25 years of follow-up. Twenty-one patients (22 hips) of the original series were alive and had clinical and radiographic follow-up at a minimum of 25 years postoperatively. Twenty-three percent (23) of all hips and 50% (11) of the hips among the living cohort had undergone revision for loosening and/or osteolysis of the acetabular component, and 7% (7) of all hips and 4.5% (1) of the hips among the living cohort were revised for loosening and/or osteolysis of the femoral component. Only 4 femoral stems were revised for isolated loosening (without osteolysis). The PCA femoral component proved to be durable at a minimum of 25 years postoperatively, while the acetabular component was less durable.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
本研究的目的是更新1983年至1986年间使用多孔涂层解剖型(PCA)系统进行的100例初次非骨水泥全髋关节置换术(THA)的前瞻性系列研究结果。这是首批对非骨水泥初次THA进行至少25年随访的前瞻性研究之一。原系列中有21例患者(22髋)存活,术后至少25年有临床和影像学随访。所有髋关节中23%(23髋)以及存活队列中50%(11髋)因髋臼部件松动和/或骨溶解而进行了翻修,所有髋关节中7%(7髋)以及存活队列中4.5%(1髋)因股骨部件松动和/或骨溶解而进行了翻修。仅4个股骨柄因单纯松动(无骨溶解)而进行了翻修。PCA股骨部件在术后至少25年时显示出耐用性,而髋臼部件耐用性较差。
治疗性IV级。有关证据水平的完整描述,请参阅作者须知。