单一品牌非骨水泥型小柄全髋关节置换翻修术——基于国家关节注册研究结果后的经验
Total Hip Replacement Revision in a Single Brand Small Cementless Stem - Our Experience after the Findings of the National Joint Registry.
作者信息
Piggott Robert Pearse, Lyons Rebecca, Murphy Colin Gerard, Curtin William
机构信息
Research performed at Department of Trauma and Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland.
Department of Trauma and Orthopaedic Surgery, Galway University Hospitals, Galway, Ireland.
出版信息
Arch Bone Jt Surg. 2018 Nov;6(6):501-507.
BACKGROUND
Cementless total hip replacement is the common THR performed in England, Wales, Northern Ireland and the Isle of Man. The Corail stem is the most popular cementless implant and has a ODEP 10A rating. Review of its performance in the registry identified an increase rate of revision amongst the smaller stem sizes. However, clarity was not provided on the explanation for this finding. We reviewed our own experience of smaller stems with a view to understanding the reasons for revision.
METHODS
We reviewed a single centre, single surgeon experience of the smaller Corail stem sizes for a ten-year period from 2003 to 2013. All data was collected from a prospectively maintained database. Details of clinical and radiological follow up were collected for all patients who had Corail stem size 8 and 9 implanted. Revision for any cause was taken as our endpoint.
RESULTS
542 patients underwent total hip arthroplasty using the Corail stem during the study period. 53 small size Corail stems were implanted. The average age was 59 (range 17-88 years) and the average follow up was 41.4 months (range 1-118 months). 6 patients underwent revision during the study period, but only 4 stems required revision. The reasons for revision were aseptic loosening, fracture and metal-on metal complications. Only two stems required revision for stem related factors (3.8%).
CONCLUSION
There was no evidence of an increased rate of revision in the small Corail stems in our cohort.
背景
非骨水泥型全髋关节置换术是在英格兰、威尔士、北爱尔兰和马恩岛进行的常见全髋关节置换术。Corail 柄是最受欢迎的非骨水泥型植入物，具有 ODEP 10A 评级。对其在登记处的性能回顾发现，较小柄尺寸的翻修率有所增加。然而，对于这一发现的解释并不明确。我们回顾了自己使用较小柄的经验，以了解翻修的原因。
方法
我们回顾了一位外科医生在 2003 年至 2013 年十年间使用较小尺寸 Corail 柄的单中心经验。所有数据均从前瞻性维护的数据库中收集。收集了所有植入 Corail 柄尺寸 8 和 9 的患者的临床和放射学随访细节。将任何原因导致的翻修作为我们的终点。
结果
在研究期间，542 例患者使用 Corail 柄进行了全髋关节置换术。植入了 53 个小尺寸 Corail 柄。平均年龄为 59 岁（范围 17 - 88 岁），平均随访时间为 41.4 个月（范围 1 - 118 个月）。在研究期间，6 例患者接受了翻修，但只有 4 个柄需要翻修。翻修原因包括无菌性松动、骨折和金属对金属并发症。只有两个柄因柄相关因素需要翻修（3.8%）。
结论
在我们的队列中，没有证据表明小尺寸 Corail 柄的翻修率增加。
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