Clement N D, Bardgett M, Merrie K, Furtado S, Bowman R, Langton D J, Deehan D J, Holland J
Department of Orthopaedics, Freeman Hospital, Newcastle upon Tyne, UK.
Northern Retrieval Registry, The Biosphere, Newcastle Helix, Newcastle upon Tyne, UK.
Bone Joint Res. 2019 Jul 5;8(6):275-287. doi: 10.1302/2046-3758.86.BJR-2018-0300.R1. eCollection 2019 Jun.
Our primary aim was to describe migration of the Exeter stem with a 32 mm head on highly crosslinked polyethylene and whether this is influenced by age. Our secondary aims were to assess functional outcome, satisfaction, activity, and bone mineral density (BMD) according to age.
A prospective cohort study was conducted. Patients were recruited into three age groups: less than 65 years (n = 65), 65 to 74 years (n = 68), and 75 years and older (n = 67). There were 200 patients enrolled in the study, of whom 115 were female and 85 were male, with a mean age of 69.9 years (sd 9.5, 42 to 92). They were assessed preoperatively, and at three, 12 and, 24 months postoperatively. Stem migration was assessed using Einzel-Bild-Röntgen-Analyse (EBRA). Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), EuroQol-5 domains questionnaire (EQ-5D), short form-36 questionnaire (SF-36,) and patient satisfaction were used to assess outcome. The Lower Extremity Activity Scale (LEAS), Timed Up and Go (TUG) test, and activPAL monitor (energy expelled, time lying/standing/walking and step count) were used to assess activity. The BMD was assessed in Gruen and Charnley zones.
Mean varus/valgus tilt was -0.77⁰ and axial subsidence was -1.20 mm. No significant difference was observed between age groups (p ⩾ 0.07). There was no difference according to age group for postoperative WOMAC (p ⩾ 0.11), HHS (p ⩾ 0.06), HOOS (p ⩾ 0.46), EQ-5D (p ⩾ 0.38), patient satisfaction (p ⩾ 0.05), or activPAL (p ⩾ 0.06). Patients 75 years and older had a worse SF-36 physical function (p = 0.01) and physical role (p = 0.03), LEAS score (p < 0.001), a shorter TUG (p = 0.01), and a lower BMD in Charnley zone 1 (p = 0.02).
Exeter stem migration is within normal limits and is not influenced by age group. Functional outcome, patient satisfaction, activity level, and periprosthetic BMD are similar across all age groups.: N. D. Clement, M. Bardgett, K. Merrie, S. Furtado, R. Bowman, D. J. Langton, D. J. Deehan, J. Holland. Cemented Exeter total hip arthroplasty with a 32 mm head on highly crosslinked polyethylene: Does age influence functional outcome, satisfaction, activity, stem migration, and periprosthetic bone mineral density? 2019;8:275-287. DOI: 10.1302/2046-3758.86.BJR-2018-0300.R1.
我们的主要目的是描述采用高度交联聚乙烯、头直径为32毫米的埃克塞特柄的移位情况，以及年龄是否会对其产生影响。我们的次要目的是根据年龄评估功能结果、满意度、活动情况和骨密度（BMD）。
进行了一项前瞻性队列研究。患者被分为三个年龄组：小于65岁（n = 65）、65至74岁（n = 68）以及75岁及以上（n = 67）。该研究共纳入200例患者，其中女性115例，男性85例，平均年龄69.9岁（标准差9.5，42至92岁）。对他们在术前以及术后3个月、12个月和24个月进行评估。采用 Einzel-Bild-Röntgen-Analyse（EBRA）评估柄的移位情况。使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、Harris髋关节评分（HHS）、髋关节功能障碍和骨关节炎结果评分（HOOS）、欧洲五维健康量表（EQ-5D）、简明健康调查问卷（SF-36）以及患者满意度来评估结果。采用下肢活动量表（LEAS）、计时起立行走测试（TUG）以及activPAL监测仪（能量消耗、躺卧/站立/行走时间和步数）来评估活动情况。在Gruen和Charnley区域评估骨密度。
平均内翻/外翻倾斜为-0.77°，轴向下沉为-1.20毫米。各年龄组之间未观察到显著差异（p⩾0.07）。术后WOMAC（p⩾0.11）、HHS（p⩾0.06）、HOOS（p⩾0.46）、EQ-5D（p⩾0.38）、患者满意度（p⩾0.05）或activPAL（p⩾0.06）在各年龄组之间也无差异。75岁及以上患者的SF-36身体功能（p = 0.01）和身体角色（p = 0.03）、LEAS评分（p < 0.001）、TUG时间较短（p = 0.01），且Charnley区域1的骨密度较低（p = 0.02）。
埃克塞特柄的移位在正常范围内，不受年龄组影响。所有年龄组的功能结果、患者满意度、活动水平和假体周围骨密度相似。作者：N. D. 克莱门特、M. 巴德gett、K. 梅里、S. 弗尔塔多、R. 鲍曼、D. J. 兰顿、D. J. 迪恩、J. 霍兰德。采用高度交联聚乙烯、头直径为32毫米的骨水泥型埃克塞特全髋关节置换术：年龄是否会影响功能结果、满意度、活动、柄的移位以及假体周围骨密度？2019年；8卷：275 - 287页。DOI：10.1302/2046 - 3758.86.BJR - 2018 - 0300.R1 。
