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[初次髋关节置换如何选择假体?最小可接受生存率:专家共识结果]

[How to select a prosthesis for a primary hip replacement? Minimum acceptable survival: results of a consensus of experts].

作者信息

Bautista M, Muskus M, Bonilla G, Mieth K, Gutiérrez C, Llinás A

机构信息

Departamento de Ortopedia y Traumatología, Hospital Universitario de la Fundación Santa Fe de Bogotá. Carrera 7 Núm. 117-15, CP 220246, Bogotá DC, Colombia.

出版信息

Acta Ortop Mex. 2017 Nov-Dec;31(6):292-299.

Abstract

BACKGROUND

One of the most critical points in the planning of hip replacement surgeries is the selection of the implant, since its survival significantly impacts the patients health. However, the ideal survival time that an implant must prove to be selected has not been defined. The objective of this consensus is to define minimum performance standards for the selection of conventional primary hip replacement prosthesis.

MATERIAL AND METHODS

The consensus was carried out using the methodology of nominal group. This included: 1. A review of the available evidence and the issues to be evaluated, 2. Meeting for the vote and discussion, 3. Quantitative statistical analysis with median (M) and interquartile range (IQR) and qualitative one with proportions of the results to generate recommendations.

RESULTS

The primary source of information for prosthesis selection (M: 8; IQR: 7-9), choice in the event of conflicting evidence (M: 8; IQR: 7-9), or limited evidence in the literature (M: 7; IQR: 4.75-825) should be national registries. The minimum acceptable follow-up is 10 years (M: 9; IQR: 8-9) and the minimum acceptable survival is 90% at 10 years (M: 8; IQR: 5-8.5).

DISCUSSION

According to these results, the consensus of experts proposed that the selection of the implant for conventional primary hip replacement must be based on the information published in the national registries and that the prosthesis must have a minimum follow-up of 10 years and show a minimum survival of 90%.

摘要

背景

髋关节置换手术规划中最关键的要点之一是植入物的选择,因为其使用寿命会显著影响患者健康。然而,尚未确定选择植入物时必须证明的理想生存时间。本共识的目的是为传统初次髋关节置换假体的选择定义最低性能标准。

材料与方法

本共识采用名义小组法进行。这包括:1. 对现有证据和待评估问题的回顾;2. 投票和讨论会议;3. 采用中位数(M)和四分位数间距(IQR)进行定量统计分析,以及采用结果比例进行定性分析以生成建议。

结果

假体选择的主要信息来源(M:8;IQR:7 - 9)、出现相互矛盾证据时的选择(M:8;IQR:7 - 9)或文献中证据有限时的选择(M:7;IQR:4.75 - 8.25)应为国家登记处。可接受的最短随访时间为10年(M:9;IQR:8 - 9),10年时可接受的最低生存率为90%(M:8;IQR:5 - 8.5)。

讨论

根据这些结果,专家共识建议,传统初次髋关节置换植入物的选择必须基于国家登记处公布的信息,并且假体必须有至少10年的随访且显示出至少90%的生存率。

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