镰状细胞病继发骨坏死的全髋关节置换术。
Total hip arthroplasty in osteonecrosis secondary to sickle cell disease.
机构信息
Department of Trauma & Orthopaedics, King's College Hospital NHS Foundation Trust, King's College London, Denmark Hill, London, SE5 9RS, UK.
Department of Haematological Medicine, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9RS, UK.
出版信息
Int Orthop. 2019 Feb;43(2):293-298. doi: 10.1007/s00264-018-4001-0. Epub 2018 Jun 15.
BACKGROUND
Sickle cell disease (SCD) is a multisystem disease, and the predominant articular manifestation is osteonecrosis (ON). Total hip arthroplasty (THA) is technically challenging, and the complication rates are high. In this retrospective study, we have analysed the outcome of THA in a cohort of patients with SCD at our institution.
MATERIALS AND METHODS
We identified 34 THAs between 1999 and 2016 in 30 patients (mean age 37 years) from our SCD database. Co-morbidities, both sickle and non-sickle-related, were documented. Complications and indications for revision surgery were analysed.
RESULTS
An uncemented prosthesis was predominantly used. The mean follow-up was 10.5 years (range 1-18). Six patients had revision surgery (17.6%), 2 (5.8%) for Prosthetic Joint Infection (PJI), and 4 (11.7%) for osteolysis of the acetabular component.
CONCLUSION
Our revision rates were comparable to the published literature. Our combined sickle cell clinic and the coordinated multidisciplinary management have been successful in reducing morbidity.
背景
镰状细胞病（SCD）是一种多系统疾病，主要的关节表现为骨坏死（ON）。全髋关节置换术（THA）技术难度大，并发症发生率高。在这项回顾性研究中，我们分析了我院 SCD 患者队列中 THA 的结果。
材料与方法
我们从 SCD 数据库中确定了 1999 年至 2016 年间 30 例患者（平均年龄 37 岁）的 34 例 THA。记录了镰状和非镰状相关的合并症。分析了并发症和翻修手术的指征。
结果
主要使用非骨水泥假体。平均随访时间为 10.5 年（范围 1-18 年）。6 例患者行翻修手术（17.6%），2 例（5.8%）为假体关节感染（PJI），4 例（11.7%）为髋臼假体骨溶解。
结论
我们的翻修率与已发表的文献相当。我们的镰状细胞联合诊所和协调的多学科管理成功地降低了发病率。
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