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初次全髋关节置换术中解剖型双动髋与模块化双动髋的比较:一项配对队列研究。

Anatomic dual mobility compared to modular dual mobility in primary total hip arthroplasty: a matched cohort study.

作者信息

Dubin J A, Westrich G H

机构信息

Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY, USA.

出版信息

Arthroplast Today. 2019 Dec 6;5(4):509-514. doi: 10.1016/j.artd.2019.09.006. eCollection 2019 Dec.

Abstract

BACKGROUND

Dual mobility (DM) has been used in primary total hip arthroplasty recently for their low dislocation rates, low revision rates, and improved patient functional outcomes. We compared 2 DM systems, anatomic dual mobility (ADM; Stryker, Mahwah, NJ) and modular dual mobility (MDM; Stryker, Mahwah, NJ), to determine differences in dislocation rates, revision rates, and patient outcome scores.

METHODS

The study was a single-center matched retrospective review of prospectively collected data of patients who underwent primary total hip arthroplasty surgery with an ADM or MDM system by a single surgeon from 2012 to 2017. Demographics, operative details, postoperative patient-reported outcomes, and clinical outcomes were recorded. A Kaplan-Meier survivorship curve to compare survival time between groups was collected as well.

RESULTS

Five hundred seventy-four patients were included in the study with 287 patients matched in each group with mean 2.86 years of follow-up. The dislocation rate in each cohort was 0%, the acetabular-specific revision rate was 0%, and in each cohort, overall revision rate in each cohort was 1.7%. In general, patient-reported outcomes were similar for each group (Harris Hip Score Pain ( = .919), Harris Hip Score Function ( = .736), Western Ontario and McMaster Universities Osteoarthritis Index ( = .139), Pain Visual Analog Scale ( = .146), Veterans RAND 12-Item Health Survey ( = .99), University of California, Los Angeles ( = .417), and Harris Hip Score Total ( = .136). There was a slight clinically insignificant increase in hip flexion between the cohorts favoring the ADM group (98.6 ± 9.8 vs 94.0 ± 9.7, < .001).

CONCLUSIONS

Both DM systems had similar patient-reported outcomes that were quite favorable. At 2.86 years of follow-up, neither the ADM nor MDM systems demonstrated dislocation, and both had low acetabular-specific and overall revision rates in this matched cohort study.

摘要

背景

双动(DM)髋关节假体最近已应用于初次全髋关节置换术,因其脱位率低、翻修率低且患者功能预后得到改善。我们比较了两种双动系统,解剖型双动(ADM;史赛克公司,新泽西州马霍瓦)和模块化双动(MDM;史赛克公司,新泽西州马霍瓦),以确定脱位率、翻修率和患者预后评分的差异。

方法

本研究是一项单中心匹配回顾性研究,回顾了2012年至2017年由一名外科医生使用ADM或MDM系统进行初次全髋关节置换手术患者的前瞻性收集数据。记录人口统计学、手术细节、术后患者报告的预后和临床结果。还收集了Kaplan-Meier生存曲线以比较组间生存时间。

结果

574例患者纳入研究,每组287例匹配患者,平均随访2.86年。每个队列的脱位率为0%,髋臼特异性翻修率为0%,每个队列的总体翻修率为1.7%。总体而言,每组患者报告的预后相似(Harris髋关节评分疼痛(P = 0.919),Harris髋关节评分功能(P = 0.736),西安大略和麦克马斯特大学骨关节炎指数(P = 0.139),疼痛视觉模拟量表(P = 0.146),退伍军人兰德12项健康调查(P = 0.99),加利福尼亚大学洛杉矶分校(P = 0.417),以及Harris髋关节评分总分(P = 0.136)。队列间髋关节屈曲有轻微的、临床上无显著意义的增加,有利于ADM组(98.6±9.8对94.0±9.7,P < 0.001)。

结论

两种双动系统患者报告的预后相似且都相当良好。在2.86年的随访中,ADM和MDM系统均未出现脱位,在这项匹配队列研究中,两者的髋臼特异性和总体翻修率均较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3d/6920720/85fc10e0fc8c/gr1.jpg

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