Costa Matthew L, Achten Juul, Foguet Pedro, Parsons Nicholas R
Oxford Trauma, NDORMS, Kadoorie Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK.
University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
BMJ Open. 2018 Mar 12;8(3):e018849. doi: 10.1136/bmjopen-2017-018849.
To compare the medium-term clinical effectiveness of total hip arthroplasty and resurfacing arthroplasty.
Single centre, two-arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation.
A large teaching hospital in England.
122 patients older than 18 years with severe arthritis of the hip joint, suitable for resurfacing arthroplasty of the hip. Patients were excluded if they were considered to be unable to adhere to trial procedures or complete questionnaires.
Total hip arthroplasty (replacement of entire femoral head and neck); hip resurfacing arthroplasty (replacement of the articular surface of femoral head only, femoral neck remains intact). Both procedures replaced the articular surface of the acetabulum.
The outcome measures were hip function assessed using the Oxford Hip Score (OHS) and health-related quality of life assessed using the EuroQol (EQ-5D). Patients were followed up annually for a minimum of 5 years. Outcome data were modelled using the generalised estimating equation methodology to explore temporal variations during follow-up.
60 patients were randomly assigned to hip resurfacing arthroplasty and 62 to total hip arthroplasty. 95 (78%) of the 122 original study participants provided data at 5 years. There was a small decrease in both hip functions and quality of life in both groups of patients each year during the 5-year follow-up period. However, there was no evidence of a significant difference between treatments group in the OHS (P=0.333) or the EQ-5D (P=0.501).
We previously reported no difference in outcome in the first year after surgery. The current medium-term results also show no evidence of a difference in hip function or health-related quality of life in the 5 years following a total hip arthroplasty versus resurfacing arthroplasty.
ISRCTN33354155. UKCRN 4093.
比较全髋关节置换术与表面置换术的中期临床疗效。
单中心、双臂、平行组、评估者盲法、1:1治疗分配的随机对照试验。
英国一家大型教学医院。
122例年龄大于18岁的严重髋关节关节炎患者，适合髋关节表面置换术。若患者被认为无法遵守试验程序或完成问卷则被排除。
全髋关节置换术（置换整个股骨头和颈）；髋关节表面置换术（仅置换股骨头的关节面，股骨颈保持完整）。两种手术均置换髋臼的关节面。
采用牛津髋关节评分（OHS）评估髋关节功能，采用欧洲五维健康量表（EQ-5D）评估健康相关生活质量。患者每年随访至少5年。采用广义估计方程方法对结局数据进行建模，以探讨随访期间的时间变化。
60例患者被随机分配至髋关节表面置换术组，62例被分配至全髋关节置换术组。122例原始研究参与者中有95例（78%）在5年时提供了数据。在5年随访期内，两组患者的髋关节功能和生活质量每年均有小幅下降。然而，治疗组在OHS（P=0.333）或EQ-5D（P=0.501）方面均无显著差异的证据。
我们之前报告术后第一年结局无差异。目前的中期结果也显示，全髋关节置换术与表面置换术后5年，在髋关节功能或健康相关生活质量方面无差异的证据。
ISRCTN33354155。UKCRN 4093。
