779 例 Metasul® 金属对金属全髋关节置换术后 11 至 21 年的存活率。

Survival at 11 to 21 years for 779 Metasul® metal-on-metal total hip arthroplasties.

机构信息

Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, Clermont-Ferrand, France.

Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France.

出版信息

J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(2):2309499020926265. doi: 10.1177/2309499020926265.

DOI:10.1177/2309499020926265

PMID:32735149

Abstract

BACKGROUND

Total hip arthroplasties (THAs) bearing is one of the most important factors for hip replacement because THA survival depends on it. Metal-on-metal (MoM) bearing has lower wear than metal-on-polyethylene but lot of aseptic loosening decrease utilization. We analyze the survival rate of 28 mm Metasul® bearings after a mean follow-up of 12.9 years.

METHODS

The main objective of this study was to evaluate the survival of the MoM. We evaluate 779 consecutive THAs performed between January 1995 and December 2005 for primary osteoarthritis, congenital dysplasia classified Crowe I, or rheumatoid arthritis. Survival rate was calculated by the Kaplan-Meir method. The association between survival and age, gender, body mass index (BMI), and surface coating was investigated with a proportional odds model. The clinical assessment included Oxford score.

RESULTS

Six hundred fifty-two THAs were reviewed. Sixty-two revisions (9.5%) were performed including 34 aseptic loosening and 11 deep infections. The survival for prosthesis with any reason at 20 years was 87% (confidence interval (CI) 83-90.2) for aseptic loosening at 20 years was 90.1% (CI 87-93.8). There was no association with age, BMI, and surface coating. Gender was significant with lower aseptic loosening for men, hazard ratio = 0.45, value = 0.035. Oxford score was 57 ± 6.7 (19-60).

CONCLUSION

The survival rate of Metasul was well and seems to be like our clinical finding. However, radiographic aseptic loosening without surgery is not included in the survival rate. The Oxford score was very good with a lot of patients with asymptomatic hip.

LEVEL OF EVIDENCE

Level IV/Retrospective study.

摘要

背景

全髋关节置换术（THA）的假体是影响髋关节置换术后生存的最重要因素之一。金属-金属（MoM）假体的磨损比金属-聚乙烯假体小，但大量的无菌性松动会降低假体的使用率。我们分析了在平均随访 12.9 年后 28mm Metasul®假体的生存率。

方法

本研究的主要目的是评估 MoM 的生存率。我们评估了 1995 年 1 月至 2005 年 12 月期间因原发性骨关节炎、克罗恩 I 型先天性发育不良或类风湿性关节炎接受初次 THA 的 779 例连续病例。生存曲线用 Kaplan-Meier 法计算。用比例优势模型研究了生存率与年龄、性别、体重指数（BMI）和表面涂层之间的关系。临床评估包括牛津评分。

结果

共回顾了 652 例 THA。62 例（9.5%）进行了翻修，其中 34 例为无菌性松动，11 例为深部感染。因任何原因在 20 年时的假体生存率为 87%（95%置信区间（CI）为 83-90.2），20 年时无菌性松动的生存率为 90.1%（95%CI 为 87-93.8）。年龄、BMI 和表面涂层与生存率无关。性别与男性无菌性松动的发生率有显著关系，危险比=0.45，P 值=0.035。牛津评分平均为 57±6.7（19-60）。