Laboratory for the Research of Musculoskeletal System "Th. Garofalidis", Medical School, National and Kapodistrian University of Athens, General Hospital of Athens KAT, Athens, Greece.
Bone Joint J. 2019 Sep;101-B(9):1050-1057. doi: 10.1302/0301-620X.101B9.BJJ-2018-1208.R1.
To our knowledge, no study has compared the long-term results of cemented and hybrid total hip arthroplasty (THA) in patients with osteoarthritis (OA) secondary to congenital hip disease (CHD). This is a demanding procedure that may require special techniques and implants. Our aim was to compare the long-term outcome of cemented low-friction arthroplasty (LFA) and hybrid THA performed by one surgeon.
Between January 1989 and December 1997, 58 hips (44 patients; one man, 43 woman; mean age 56.6 years (25 to 77)) with OA secondary to CHD were treated with a cemented Charnley LFA (group A), and 55 hips (39 patients; two men, 37 women; mean age 49.1 years (27 to 70)) were treated with a hybrid THA (group B), by the senior author (GH). The clinical outcome and survivorship were compared.
At all timepoints, group A hips had slightly better survivorship than those in group B without a statistically significant difference, except for the 24-year survival of acetabular components with revision for aseptic loosening as the endpoint, which was slightly worse. The survivorship was only significantly better in group A compared with group B when considering reoperation for any indication as the endpoint, 15 years postoperatively (74% 52%, p = 0.018).
We concluded that there was not a substantial difference at almost any time in the outcome of cemented Charnley LFAs compared with hybrid THAs when treating patients with OA of the hip secondary to CHD. We believe, however, that after improvements in the design of components used in hybrid THA, this could be the method of choice, as it is technically easier with a shorter operating time. Cite this article: 2019;101-B:1050-1057.
据我们所知,尚无研究比较过因先天性髋关节疾病(CHD)继发骨关节炎(OA)患者行骨水泥型和混合型全髋关节置换术(THA)的长期结果。这是一项要求较高的手术,可能需要特殊的技术和植入物。我们的目的是比较同一位外科医生行骨水泥型低摩擦关节置换术(LFA)和混合型 THA 的长期结果。
1989 年 1 月至 1997 年 12 月,采用骨水泥型 Charnley LFA 治疗因 CHD 继发 OA 的 58 髋(44 例患者;1 例男性,43 例女性;平均年龄 56.6 岁(25 至 77 岁))(A 组),采用混合型 THA 治疗 55 髋(39 例患者;2 例男性,37 例女性;平均年龄 49.1 岁(27 至 70 岁))(B 组),均由资深作者(GH)完成。比较了临床结果和存活率。
在所有时间点,A 组髋关节的存活率均略优于 B 组,但无统计学差异,除了以翻修时因无菌性松动而导致的髋臼部件 24 年存活率作为终点时,A 组略差。仅当以任何原因再次手术作为终点时,A 组的存活率在术后 15 年时明显优于 B 组(74%对 52%,p = 0.018)。
我们的结论是,在治疗因 CHD 继发 OA 的髋关节患者时,与混合型 THA 相比,骨水泥型 Charnley LFA 的结果在几乎任何时候都没有明显差异。然而,我们认为,随着混合型 THA 中所用部件设计的改进,这可能成为首选方法,因为其技术上更简单,手术时间更短。
2019;101-B:1050-1057.