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多孔钽植入失败后改行全髋关节置换术治疗股骨头坏死的疗效:一项配对病例对照研究

Outcomes of conversion THA after failed porous tantalum implant for osteonecrosis of the femoral head: a comparative matched study.

机构信息

Centre for Osteonecrosis and Joint Preserving and Reconstruction, Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China.

出版信息

Hip Int. 2020 Nov;30(6):703-710. doi: 10.1177/1120700019863036. Epub 2019 Jul 11.

DOI:10.1177/1120700019863036
PMID:31296056
Abstract

BACKGROUND

As a joint-preserving surgery, porous tantalum implantation (PTI) provides an additional treatment option for osteonecrosis of the femoral head (ONFH). However, conversion to a total hip arthroplasty (THA) after failed PTI is considered a challenging procedure. The purpose of this study was to compare the clinical and radiologic outcomes and complications of THA after failed PTI with those of primary THA without any previous surgery for ONFH.

METHODS

This retrospective study included 32 patients undergoing THA after failed PTI and 25 age, sex, and body mass index matched patients who underwent primary THA without any previous surgery for ONFH between December 2009 and March 2014. All patients were followed for at least 36 months. The postoperative clinical and radiological evaluations were based on Harris Hip Score (HHS) and plain radiographs. The independent sample test and the chi-square test were used for the statistical analysis.

RESULTS

The HHS in the PTI group was similar to that in the primary group at the latest follow-up ( 0.274), but longer operation time and greater intraoperative blood loss were observed in the PTI group ( 0.001, respectively). No significant differences in radiological parameters and postoperative complications were found between the 2 groups ( > 0.05).

CONCLUSIONS

THA after PTI showed similar clinical and radiological outcomes to primary THA except for longer operation time and greater intraoperative blood loss.

摘要

背景

作为一种保关节手术,多孔钽植入(PTI)为股骨头坏死(ONFH)提供了另一种治疗选择。然而,PTI 失败后转为全髋关节置换术(THA)被认为是一项具有挑战性的手术。本研究的目的是比较 PTI 失败后行 THA 与初次行 THA 治疗无既往 ONFH 手术史患者的临床和影像学结果及并发症。

方法

本回顾性研究纳入了 2009 年 12 月至 2014 年 3 月间行 PTI 失败后行 THA 的 32 例患者和 25 例性别、年龄和身体质量指数匹配的初次行 THA 治疗无既往 ONFH 手术史患者。所有患者均随访至少 36 个月。术后临床和影像学评估基于 Harris 髋关节评分(HHS)和 X 线平片。采用独立样本 t 检验和卡方检验进行统计学分析。

结果

PTI 组在末次随访时的 HHS 与初次组相似( 0.274),但 PTI 组手术时间较长( 0.001),术中出血量较大( 0.001)。两组在影像学参数和术后并发症方面无显著差异( > 0.05)。

结论

除手术时间较长和术中出血量较大外,PTI 失败后行 THA 的临床和影像学结果与初次 THA 相似。

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