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使用非骨水泥型带螺纹髋臼杯和股骨柄进行犬全髋关节置换:55例病例回顾

Canine total hip replacement using a cementless threaded cup and stem: a review of 55 cases.

作者信息

Denny H R, Linnell M, Maddox T W, Comerford E J

机构信息

Fernlea Veterinary Clinic, Hanham, Bristol, BS15 3EW, UK.

Institute of Ageing and Chronic Disease, William Henry Duncan building, Liverpool, L6 2AF, UK.

出版信息

J Small Anim Pract. 2018 Jun;59(6):350-356. doi: 10.1111/jsap.12827. Epub 2018 Mar 25.

Abstract

OBJECTIVES

To determine the long-term results and complications associated with the Helica cementless hip endoprosthesis system.

MATERIALS AND METHODS

Retrospective study of 55 consecutive Helica total hip replacements performed between January 2010 and February 2015.

RESULTS

A total of 55 total hip replacements were performed in 50 dogs; 45 dogs had unilateral hip replacements, and five had staged bilateral replacements. A total of 23 first-generation short femoral stems were implanted in 22 dogs, of which nine cases (39%) experienced complications and 19 (86%) recovered satisfactorily when revisions were included; 31 second-generation femoral stems were implanted in 28 dogs, of which 10 cases (32%) experienced complications, and 26 (93%) made satisfactory recoveries, including revisions. In 36 dogs for which data were available, postoperative Liverpool Osteoarthritis in Dogs scores were significantly reduced compared to preoperative scores. Complications occurred in a total of 19 cases (34·5%; 95% confidence interval: 22 to 47·1%); the most common was aseptic loosening of the femoral stem [11 cases (20%; 95% confidence interval: 9·4 to 30·6%)]. Following multivariable analysis, no risk factors were identified for overall complications, but there was a significant association of implant type (first-generation short stem) with loosening (odds ratio 4·9, 95% confidence interval: 1·1 to 22·1, P=0·034).

CLINICAL SIGNIFICANCE

This study found the Helica hip endoprosthesis system to be effective in the management of hip dysplasia and osteoarthritis in dogs. Aseptic loosening of the femoral stem remains the most common complication but appears to have been significantly reduced with the introduction of the second-generation stem.

摘要

目的

确定Helica非骨水泥型髋关节假体系统的长期效果及相关并发症。

材料与方法

对2010年1月至2015年2月间连续进行的55例Helica全髋关节置换术进行回顾性研究。

结果

共对50只犬进行了55例全髋关节置换术;45只犬进行了单侧髋关节置换,5只进行了分期双侧置换。共22只犬植入了23个第一代短股骨干假体,其中9例(39%)出现并发症,包括翻修病例在内,19例(86%)恢复良好;28只犬植入了31个第二代股骨干假体,其中10例(32%)出现并发症,包括翻修病例在内,26例(93%)恢复良好。在有数据的36只犬中,术后犬类利物浦骨关节炎评分与术前相比显著降低。共有19例(34.5%;95%置信区间:22%至47.1%)出现并发症;最常见的是股骨干无菌性松动[11例(20%;95%置信区间:9.4%至30.6%)]。多变量分析后,未发现总体并发症的危险因素,但植入物类型(第一代短柄)与松动有显著相关性(优势比4.9,95%置信区间:1.1至22.1,P = 0.034)。

临床意义

本研究发现Helica髋关节假体系统在治疗犬髋关节发育不良和骨关节炎方面有效。股骨干无菌性松动仍是最常见的并发症,但随着第二代假体的引入,其发生率似乎已显著降低。

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