Moreta Jesús, Uriarte Iker, Foruria Xabier, Loroño Ane, Agirre Urko, Jáuregui Iñaki, Martínez-de Los Mozos José Luis
Department of Orthopaedic Surgery and Trauma, Hospital Galdakao-Usansolo, Barrio Labeaga s/n, 48960, Galdakao, Bizkaia, Spain.
Research Unit, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain.
Eur J Orthop Surg Traumatol. 2018 Oct;28(7):1327-1334. doi: 10.1007/s00590-018-2213-z. Epub 2018 Apr 25.
The objective of this study was to analyse results achieved with the S-ROM modular stem in revision surgery.
A retrospective observational study was conducted from 2007 to 2015 including 51 patients who had a follow-up of ≥ 2 years and complete medical history. The mean age was 66.5 years old (34-87). The main reason for revision was aseptic loosening (38 cases, 74.5%), followed by infection (10, 19.6%), instability (2, 3.9%) and an adverse reaction associated with a metal-on-metal hip implant (1, 2%). Using the Paprosky classification, there were 22 cases of type I (43.1%), 27 of type II (52.9%) and 2 of type IIIA (4%). At the end of the follow-up, radiological parameters were assessed using Engh's criteria. Pre- and postoperative clinical status was assessed using the Harris Hip Score, a visual analogue scale and the Merle D'Aubigné score.
The mean follow-up period was 5.7 years (2-10). The mean Harris Hip Score improved from 45.5 points (22-65) to 85.8 (55-100) (p < 0.001), and the final mean Merle D'Aubigné scores were 5.2, 4.6 and 5.6 for pain, ability to walk and mobility, respectively. Osseointegration was confirmed in all except one patient with fibrous non-union. No aseptic loosening has been recorded. Postoperative complications were deep infection in four cases (7.8%) and dislocation in three (5.9%).
This study indicates good medium-term outcomes using a modular hip replacement system with porous-coated proximal sleeves in revision surgery in patients with Paprosky type I and II defects.
本研究的目的是分析S-ROM模块化股骨柄在翻修手术中的效果。
对2007年至2015年进行的一项回顾性观察研究进行分析，纳入51例随访时间≥2年且有完整病史的患者。平均年龄为66.5岁（34 - 87岁）。翻修的主要原因是无菌性松动（38例，74.5%），其次是感染（10例，19.6%）、不稳定（2例，3.9%）以及与金属对金属髋关节植入物相关的不良反应（1例，2%）。根据Paprosky分类，I型22例（43.1%），II型27例（52.9%），IIIA型2例（4%）。随访结束时，采用Engh标准评估放射学参数。术前和术后的临床状况采用Harris髋关节评分、视觉模拟量表和Merle D'Aubigné评分进行评估。
平均随访期为5.7年（2 - 10年）。Harris髋关节评分平均从45.5分（22 - 65分）提高到85.8分（55 - 100分）（p < 0.001），最终疼痛、行走能力和活动度的平均Merle D'Aubigné评分分别为5.2、4.6和5.6。除1例纤维性骨不连患者外，所有患者均证实有骨整合。未记录到无菌性松动。术后并发症包括4例深部感染（7.8%）和3例脱位（5.9%）。
本研究表明，在Paprosky I型和II型缺损患者的翻修手术中，使用带有多孔涂层近端套筒的模块化髋关节置换系统可获得良好的中期效果。
