Orthopaedic Surgeon, Kennedy Center for the Hip and Knee, Oshkosh, Wisconsin.
Internal Medicine, Gundersen Healthcare, LaCrosse, Wisconsin.
J Arthroplasty. 2018 Feb;33(2):496-499. doi: 10.1016/j.arth.2017.09.002. Epub 2017 Sep 14.
The purpose of this study is to evaluate the outcome of revision total hip arthroplasty using an uncemented deep profile jumbo acetabular component in patients who had been followed for a minimum of 10 years postoperatively.
Between 1997 and 2001, 61 revision total hip arthroplasties were performed in 58 patients, with use of the +5 Deep Profile acetabular shell. The outcome with regard to retention vs re-revision of the acetabular component was determined for every hip. At a mean of 13 years (range 10-16) postoperatively, 30 patients (32 hips) were living. The Harris hip score, radiographic results, complications, and Kaplan-Meier survivorship were evaluated.
In the entire cohort of 61 hips, 4 acetabular components have been re-revised. Two shells were re-revised for sepsis: 1 shell was re-revised for aseptic loosening and 1 for recurrent dislocation. In the 32 hips followed for a minimum of 10 years postoperatively, 2 cups have been re-revised: 1 for aseptic loosening and 1 for recurrent dislocation. One additional shell was loose by radiographic criteria. With failure defined as re-revision for any reason, implant survival (95% confidence interval) was 92.6% (81.0-97.2) at 16 years. With failure defined as re-revision for aseptic loosening, implant survival was 97.4% (82.8-99.6) at 16 years.
Revision total hip arthroplasty with the +5 Deep Profile acetabular component was associated with a good rate of survival at 16 years.
本研究的目的是评估在至少 10 年随访的患者中使用非骨水泥深型大杯臼假体进行翻修全髋关节置换术的结果。
1997 年至 2001 年间，58 例患者 61 例接受翻修全髋关节置换术，采用+5 深型髋臼壳。确定每例髋关节髋臼假体保留与再翻修的结果。术后平均 13 年（10-16 年），30 例患者（32 髋）存活。评估 Harris 髋关节评分、影像学结果、并发症和 Kaplan-Meier 生存率。
在 61 例髋关节中，有 4 例髋臼假体被再次翻修。2 个壳因感染而被再次翻修：1 个壳因无菌性松动而被再次翻修，1 个因复发性脱位而被再次翻修。在至少随访 10 年的 32 髋中，有 2 个杯被再次翻修：1 个因无菌性松动，1 个因复发性脱位。另外一个壳也有放射学松动的迹象。以任何原因再次翻修为失效标准，16 年时植入物存活率（95%置信区间）为 92.6%（81.0-97.2）。以无菌性松动再翻修为失效标准，16 年时植入物存活率为 97.4%（82.8-99.6）。
使用+5 深型髋臼壳进行翻修全髋关节置换术，16 年时存活率较高。
