Assi Chahine, Kheir Nadim, Samaha Camille, Kouyoumjian Pascal, Yammine Kaissar
Department of Orthopedic Surgery, Lebanese American University-Rizk Hospital, Beirut, Lebanon.
Department of Orthopedic Surgery, Lebanese American University-Rizk Hospital, Beirut, Lebanon - Department of Orthopedic Surgery, Middle East Institute of Health, Bsalim, Lebanon.
SICOT J. 2018;4:4. doi: 10.1051/sicotj/2018001. Epub 2018 Feb 21.
Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH. The aim of the study is to report the early outcomes of patients with ONFH treated with THA-DMC.
A retrospective analysis of patients suffering from ONFH who underwent THA using DMC (THA-DMC) from 2006 to 2015 were evaluated for functional status and risk of post-operative complications. Thirty THA-DMC in 26 patients with a mean follow-up of 51 months were evaluated clinically (modified Hip Harris Score) and radiologically.
The mean age of the included patients was 54.9 years. At final follow-up, the mean modified Hip Harris score was 98.7 ± 2.7 and no dislocation episodes or revision surgeries were recorded. The radiological assessment revealed no signs of migration/tilting, radiolucent lines, periprosthetic osteolysis or heterotopic ossification over the DMC component and the femoral stem. The survival rate over 51 months of follow-up was 100%.
The use of the new generation of dual mobility cup in patients with ONFH showed excellent functional early results with no major complications such as dislocation.
股骨头坏死(ONFH)对于接受全髋关节置换术(THA)的患者而言仍是一个治疗挑战。这些患者大多较为年轻,功能需求较高,且与骨关节炎患者相比,术后脱位风险增加。与传统髋臼杯相比,使用双动髋臼杯(DMC)与较低的并发症发生率相关;然而,关于DMC在ONFH患者中的研究结果的文献却很匮乏。本研究的目的是报告采用THA-DMC治疗的ONFH患者的早期疗效。
对2006年至2015年期间接受THA-DMC治疗的ONFH患者进行回顾性分析,评估其功能状态和术后并发症风险。对26例患者的30个THA-DMC进行了平均51个月的随访,从临床(改良髋关节Harris评分)和影像学方面进行评估。
纳入患者的平均年龄为54.9岁。在末次随访时,平均改良髋关节Harris评分为98.7±2.7,未记录到脱位事件或翻修手术。影像学评估显示,DMC组件和股骨干未出现移位/倾斜、透亮线、假体周围骨溶解或异位骨化迹象。51个月随访期内的生存率为100%。
在ONFH患者中使用新一代双动髋臼杯显示出良好的早期功能结果,且无脱位等主要并发症。