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在年龄小于40岁的患者中,采用36毫米金属股骨头与第一代高度交联聚乙烯作为关节面进行全髋关节置换的结果:至少十年随访结果

Results of Total Hip Arthroplasty with 36-mm Metallic Femoral Heads on 1st Generation Highly Cross Linked Polyethylene as a Bearing Surface in Less than Forty Year-old Patients: Minimum Ten-year Results.

作者信息

Choi Won Kee, Kim Jae Jung, Cho Myung-Rae

机构信息

Department of Orthopaedic Surgery, Daegu Catholic University College of Medicine, Daegu, Korea.

出版信息

Hip Pelvis. 2017 Dec;29(4):223-227. doi: 10.5371/hp.2017.29.4.223. Epub 2017 Dec 1.

Abstract

PURPOSE

We evaluated long-term clinical and radiographic results in patients underwent primary total hip arthroplasty (THA) using 36-mm metallic femoral head and 1st generation highly cross-linked polyethylene among patients aged 40 years and less, with minimum 10 years follow-up.

MATERIALS AND METHODS

We retrospectively reviewed 20 hips underwent primary THA by one hip surgeon using 36-mm femoral head and 1st generation highly cross-linked polyethylene from 2004 to 2006. Mean follow up was 131.55 months. Clinical follow-ups included functional measurements. And we evaluated post operative complications, prosthesis loosening, failure, and osteolysis. For radiologic evaluations, together with position of acetabular cup at 6 weeks later of postoperation, we separately calculated the penentrations of femoral heads into polyethylene liners during postoperation and one year later check-ups, and during one year later check-ups and final check-ups. Polywear pro3D 5.10 software was used to measure penetrations of femoral head.

RESULTS

Mean acetabular cup inclination and anteversion were 49.02° and 10.19°, respectively. Mean thickness of the polyethylene liner at 45° was 6.44 mm. There were no major complications such as implant loosening or osteolysis, and one case of dislocation occurred. Average modified Harris hip score at final follow-up was 91, and Merle d'Aubigne and Postel scores 15 were or over. Average femoral head penetration of bedding wear was 0.170±0.039 mm/year. Steady-state wear rates was 0.059±0.006 mm/year.

CONCLUSION

Results of THA with 36-mm metallic femoral heads on 1st generation highly cross linked as a bearing surface in less than 40 year-old patients were satisfactory.

摘要

目的

我们评估了年龄在40岁及以下、接受初次全髋关节置换术(THA)且使用36毫米金属股骨头和第一代高度交联聚乙烯的患者的长期临床和影像学结果,并进行了至少10年的随访。

材料与方法

我们回顾性分析了2004年至2006年期间由一位髋关节外科医生对20例患者进行的初次THA,使用的是36毫米股骨头和第一代高度交联聚乙烯。平均随访时间为131.55个月。临床随访包括功能测量。我们评估了术后并发症、假体松动、失败和骨溶解情况。对于影像学评估,除了术后6周时髋臼杯的位置外,我们分别计算了术后、术后1年检查以及术后1年检查和最终检查期间股骨头进入聚乙烯内衬的穿透情况。使用Polywear pro3D 5.10软件测量股骨头的穿透情况。

结果

髋臼杯平均倾斜角和前倾角分别为49.02°和10.19°。45°时聚乙烯内衬的平均厚度为6.44毫米。未出现植入物松动或骨溶解等主要并发症,发生了1例脱位。最终随访时改良Harris髋关节平均评分为91分,Merle d'Aubigne和Postel评分均为15分及以上。平均床面磨损的股骨头穿透率为0.170±0.039毫米/年。稳态磨损率为0.059±0.006毫米/年。

结论

在40岁以下患者中,以第一代高度交联的36毫米金属股骨头作为承重表面进行THA的结果令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42ae/5729163/104b589bfc0f/hp-29-223-g001.jpg

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