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羟基磷灰石涂层非骨水泥髋臼杯治疗快速进展性髋关节骨关节炎:至少 10 年随访结果。

Total hip arthroplasty using hydroxyapatite-coated cementless cup for rapidly destructive coxarthrosis: Minimum 10-year follow-up.

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.

Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.

出版信息

J Orthop Sci. 2021 Mar;26(2):225-229. doi: 10.1016/j.jos.2020.03.009. Epub 2020 Apr 6.

Abstract

BACKGROUND

Performing total hip arthroplasty (THA) as early as possible is recommended for rapidly destructive coxarthrosis (RDC) as it causes pain that becomes progressively more severe. However, acetabular bone loss remains an issue in THA. Special devices, such as a Kerboull-type plate, may be used for acetabular bone defects, but the procedure is highly invasive and often the patients are elderly, further complicating matters. We retrospectively investigated the clinical and radiographic results of THA using conventional hydroxyapatite-coated cementless cup in RDC.

METHODS

A total of 32 patients (35 hips) with RDC were enrolled in the study with a minimum 10-year follow-up. All THAs were performed using conventional hydroxyapatite-coated cementless cup. All patients were evaluated clinically according to the Harris hip score (HHS). Acetabular bone deficiency was classified according to the American Academy of Orthopaedic Surgeons (AAOS) classification.

RESULTS

Eleven hips (31%) were AAOS type III, and none were type IV. Total HHS significantly improved from 36.5 to 79.4 (p < 0.01). Two cups exhibited loosening. The overall implant-associated survival rate after 10 years was 91.4%.

CONCLUSIONS

Clinical results of THA using conventional cementless implants for patients with RDC were acceptable. Thus, THA using conventional cementless implant is an effective and safe surgery for patients with RDC, minimizing surgical stress.

摘要

背景

对于快速进展性骨关节炎(RDC),建议尽早行全髋关节置换术(THA),因为其可引起逐渐加重的疼痛。然而,THA 仍存在髋臼骨丢失的问题。特殊装置,如 Kerboull 型钢板,可用于髋臼骨缺损,但该手术具有高度侵袭性,且患者通常为老年人,使情况更加复杂。我们回顾性研究了常规羟基磷灰石涂层非骨水泥髋臼杯在 RDC 中的 THA 的临床和影像学结果。

方法

本研究共纳入 32 例(35 髋)RDC 患者,随访时间至少 10 年。所有 THA 均采用常规羟基磷灰石涂层非骨水泥髋臼杯进行。所有患者均根据 Harris 髋关节评分(HHS)进行临床评估。髋臼骨缺损根据美国矫形外科医师学会(AAOS)分类进行分类。

结果

11 髋(31%)为 AAOS Ⅲ型,无Ⅳ型。总 HHS 从 36.5 分显著改善至 79.4 分(p<0.01)。有 2 个髋臼杯出现松动。10 年后,总体与植入物相关的生存率为 91.4%。

结论

对于 RDC 患者,使用常规非骨水泥植入物进行 THA 的临床结果是可以接受的。因此,对于 RDC 患者,使用常规非骨水泥植入物的 THA 是一种有效且安全的手术,可以最大限度地减少手术应激。

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