Department of Orthopaedic Surgery, Cappagh National Orthopaedic Hospital, Dublin, Ireland.
Ir J Med Sci. 2019 Aug;188(3):879-883. doi: 10.1007/s11845-018-01956-8. Epub 2018 Dec 19.
To establish the mode of failure of primary total hip replacement in patients under 50 years old.
A total of 1062 revision total hip arthroplasties were performed over a 5-year period, with 146 on patients under 50 years old. These were subdivided into early (< 5 years) and late (> 5 years) failures from the index procedure.
The commonest mechanism of failure was aseptic loosening (42.3%) followed by metal-on-metal failure (15.8%), infection (14.4%) and instability (9.6%). The commonest cause of early revision surgery was due to metal-on-metal failure (27.8%) followed by aseptic loosening (19.7%) and infection (18.4%). In the late revision group, the main cause of failure was aseptic loosening (64%) and infection (10.7%).
The changing trend of early revision due to metal-on-metal failure is important to recognise. Continuous review of the mechanism of primary total hip replacement failure is necessary to ensure the best patient outcome and maximise implant survivorship.
确定 50 岁以下初次全髋关节置换失败的模式。
在 5 年期间共进行了 1062 例翻修全髋关节置换术，其中 146 例患者年龄在 50 岁以下。这些患者根据索引手术分为早期（<5 年）和晚期（>5 年）失败。
最常见的失败机制是无菌性松动（42.3%），其次是金属对金属失败（15.8%）、感染（14.4%）和不稳定（9.6%）。早期翻修手术的常见原因是金属对金属失败（27.8%），其次是无菌性松动（19.7%）和感染（18.4%）。在晚期翻修组中，失败的主要原因是无菌性松动（64%）和感染（10.7%）。
认识到金属对金属失败导致早期翻修的变化趋势很重要。需要不断审查初次全髋关节置换失败的机制，以确保患者获得最佳结果并最大限度地提高植入物存活率。
