Chang Jun-Dong, Kim In-Sung, Mansukhani Sameer Ajit, Sharma Vishwas, Lee Sang-Soo, Yoo Je-Hyun
1 Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, Republic of Korea.
2 Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.
J Orthop Surg (Hong Kong). 2018 May-Aug;26(2):2309499018783913. doi: 10.1177/2309499018783913.
The purpose of this study is to evaluate the clinical and radiologic outcomes after revision total hip arthroplasty (THA) using fourth-generation ceramic-on-ceramic (CoC) bearing surfaces.
A total of 52 revision THAs (28 men and 19 women) using the fourth-generation CoC bearing surfaces were retrospectively evaluated. Both acetabular cup and femoral stem were revised in all cases. The mean follow-up period was 7.3 years (range, 4.0-9.9 years). The clinical results with Harris hip score (HHS), Western Ontario McMaster Osteoarthritis Index (WOMAC), and radiologic outcomes were evaluated.
At the final follow-up examination, the average HHS was 90.4 (range, 67-100). The average WOMAC pain and physical function score were 2.8 (range, 0-12) and 16.4 (range, 0-42), respectively. Complications were observed in 10 hips (19.2%). However, there were no bearing surface-related complications, and no cases of dislocation and squeaking. Retroacetabular pelvic osteolysis without cup loosening was observed in one hip at the final follow-up. However, no hip showed radiographic signs of cup loosening, vertical or horizontal acetabular cup migrations, and changes of inclinations during the follow-up period.
Our data showed that clinical and radiologic outcomes after revision THA using fourth-generation CoC bearing were favorable. Hence, revision THA with the use of CoC bearing surfaces can be preferentially considered. Further studies with long-term follow-up data are warranted.
本研究旨在评估使用第四代陶瓷对陶瓷（CoC）关节面进行翻修全髋关节置换术（THA）后的临床和放射学结果。
回顾性评估了总共52例使用第四代CoC关节面的翻修THA（28例男性和19例女性）。所有病例均对髋臼杯和股骨柄进行了翻修。平均随访期为7.3年（范围4.0 - 9.9年）。采用Harris髋关节评分（HHS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估临床结果，并评估放射学结果。
在最后一次随访检查时平均HHS为90.4（范围67 - 100）。WOMAC疼痛和身体功能评分的平均值分别为2.8（范围0 - 12）和16.4（范围0 - 42）。10例髋关节（19.2%）出现并发症。然而，未观察到与关节面相关的并发症，也没有脱位和异响病例。在最后一次随访时，1例髋关节观察到髋臼后方骨盆骨溶解但髋臼杯未松动。然而，在随访期间没有髋关节出现髋臼杯松动、髋臼杯垂直或水平移位以及倾斜度改变的放射学迹象。
我们的数据表明，使用第四代CoC关节面进行翻修THA后的临床和放射学结果良好。因此，可以优先考虑使用CoC关节面进行翻修THA。有必要进行长期随访数据的进一步研究。
