Kiran Manish, Santhapuri Sunil, Moeen Sara, Merchant Irfan, Arvinte Dan, Sood Manoj
Bedford Hospital, Bedford, UK.
Hip Int. 2019 Jul;29(4):393-397. doi: 10.1177/1120700019832260. Epub 2019 Feb 25.
We present the 10-year results of the ReCap Magnum HRA system in a consecutive single surgeon's series from a non-designer centre.
Hip resurfacing arthroplasty (HRA) was performed in active males under 65 years and in pre-menopausal females with adequate bone density proven by a DEXA scan. Clinical follow-up; annual Oxford hip scoring, UCLA scoring and whole blood metal ion level measurement. Kaplan-Meier method was used to determine survivorship with revision as the end point. Radiographs were analysed for; acetabular inclination, notching, neck thinning and change in implant position. 72 HRAs were performed in 66 patients with a mean age of 45.7 years. The mean follow-up was 10.63 ± 0.54 years (range 10-11.75 years).
The survivorship of the cohort at minimum 10 years was 97.22% (95% confidence interval 94.14-99.01). There was a significant improvement in the Oxford Hip Score from 15.77 ± 4.33 to 45.67 ± 4.43 ( < 0.001) and the UCLA score from 3.14 ± 0.74 to 7.07 ± 1.16 ( < 0.001). Mean whole blood cobalt and chromium levels were 28.83 ± 8.42 nmol/l and 39.93 ± 9.64 nmol/l respectively. There were 2 revisions, due to avascular necrosis and implant failure. In our series the implant has performed well with <1% failure per year. We did not note any difference between the genders, since all the females in our series had been screened for osteopenia using a DEXA scan. All our patients returned to an active lifestyle which was maintained at final follow-up.
Strict selection criteria and a well-designed implant result in good long-term functional and radiological results with hip resurfacing.
我们展示了在一个非设计中心由同一位外科医生连续进行的一系列手术中，ReCap Magnum HRA系统的10年结果。
对65岁以下的活跃男性以及经双能X线吸收法扫描证实骨密度充足的绝经前女性进行髋关节表面置换术（HRA）。进行临床随访；每年进行牛津髋关节评分、加州大学洛杉矶分校（UCLA）评分以及全血金属离子水平测量。采用Kaplan-Meier方法以翻修为终点确定生存率。对X线片进行分析，观察髋臼倾斜度、切迹、颈部变细以及植入物位置的变化。对66例患者进行了72次HRA手术，平均年龄为45.7岁。平均随访时间为10.63±0.54年（范围为10 - 11.75年）。
该队列至少10年的生存率为97.22%（95%置信区间94.14 - 99.01）。牛津髋关节评分从15.77±4.33显著提高至45.67±4.43（<0.001），UCLA评分从3.14±0.74提高至7.07±1.16（<0.001）。全血钴和铬的平均水平分别为28.83±8.42纳摩尔/升和39.93±9.64纳摩尔/升。有2例翻修，原因是缺血性坏死和植入物失败。在我们的系列研究中，植入物表现良好，每年失败率<1%。我们未发现性别之间存在差异，因为我们系列中的所有女性均已通过双能X线吸收法扫描筛查过骨质减少情况。我们所有的患者都恢复了积极的生活方式，并且在最终随访时得以维持。
严格的选择标准和精心设计的植入物可使髋关节表面置换术获得良好的长期功能和影像学结果。
