Higuchi Yoshitoshi, Seki Taisuke, Hasegawa Yukiharu, Takegami Yasuhiko, Morita Daigo, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hip Int. 2019 Jan;29(1):65-71. doi: 10.1177/1120700018760971. Epub 2018 Apr 23.
: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period.
: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed.
: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465).
: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.
本研究旨在比较28毫米陶瓷对陶瓷（CoC）全髋关节置换术（THA）与32毫米CoC全髋关节置换术在5至15年随访期内的临床和影像学结果。
107个关节（95名女性和6名男性）接受了28毫米CoC全髋关节置换术，60个关节（49名女性和7名男性）接受了32毫米CoC全髋关节置换术。28毫米和32毫米CoC组患者手术时的平均年龄分别为56.1岁和55.7岁。对所有患者进行了临床和放射学测量分析。
两组术前Harris髋关节评分（HHS）均值相似（28毫米组为58.9，32毫米组为58.5）。然而，在最终随访时，32毫米CoC组的平均HHS（91.8）显著优于28毫米CoC组（88.2）（p = 0.003），屈伸活动范围（ROM）（98.3±13.5°对87.3±19.3°，p < 0.001）和外展活动范围（27.8±14.9°对22.1±19.3°，p = 0.007）也是如此。28毫米CoC的平均磨损率为每年0.0044毫米，32毫米CoC的平均磨损率为每年0.0044毫米。两组均未发现陶瓷骨折。28毫米CoC组有1个关节（0.9%）因进行性骨溶解需要翻修。以植入物松动或翻修THA为终点，28毫米CoC在10年时的Kaplan-Meier生存率为98.3%，32毫米CoC为100%（p = 0.465）。
两组之间与陶瓷相关的并发症无显著差异。我们的研究表明，32毫米和28毫米CoC是安全的，且临床效果良好。
