The Joint Replacement Institute at St Vincent Medical Center, Los Angeles, California, USA.
Bone Joint J. 2020 Oct;102-B(10):1289-1296. doi: 10.1302/0301-620X.102B10.BJJ-2020-0147.R2.
Hip resurfacing arthroplasty (HRA) is typically indicated for young and active patients. Due to the longevity of arthroplasty, these patients are likely to undergo revision surgery during their lifetime. There is a paucity of information on the long-term outcome of revision surgeries performed after failed HRA. The aim of our study was to provide survivorship data as well as clinical scores after HRA revisions.
A total of 42 patients (43 hips) were revised after HRA at our centre to a variety of devices, including four HRA and 39 total hip arthroplasties (THAs). In addition to perioperative complications, University of California, Los Angeles (UCLA) hip scores and 12-Item Short-Form Health Survey questionnaire (SF-12) quality of life scores were collected at follow-up visits after the primary HRA and after revision surgery.
The mean follow-up time after revision surgery was 8.3 years (0.3 to 19.1). The mean UCLA pain and function scores post-revision were comparable with the best scores achieved by the patients after the index HRA, but UCLA activity scores were lower after revision. SF-12 physical component scores were comparable between timepoints, but the mental component score decreased after revision. Six patients underwent unilateral re-revision surgery at a mean follow-up time of 7.8 years (0.3 to 13.7). Using the time to any re-revision as endpoint, the Kaplan-Meier survivorship was 85.3% at 13 years.
Patients undergoing revision after HRA can expect to achieve function and quality of life similar to their best after their primary surgery, while the risk of re-revision is low. Cite this article: 2020;102-B(10):1289-1296.
髋关节表面置换术(HRA)通常适用于年轻且活跃的患者。由于关节置换术的寿命较长,这些患者在其一生中可能需要接受翻修手术。关于 HRA 失败后进行的翻修手术的长期结果,相关信息有限。我们的研究旨在提供生存数据以及 HRA 翻修后的临床评分。
在我们中心,共有 42 名患者(43 髋)因各种器械而接受了 HRA 翻修,包括 4 例 HRA 和 39 例全髋关节置换术(THA)。除围手术期并发症外,我们还在初次 HRA 和翻修手术后的随访中收集了加利福尼亚大学洛杉矶分校(UCLA)髋关节评分和 12 项简明健康调查问卷(SF-12)生活质量评分。
翻修手术后的平均随访时间为 8.3 年(0.3 至 19.1 年)。翻修后 UCLA 疼痛和功能评分与患者在初次 HRA 后获得的最佳评分相当,但 UCLA 活动评分较低。SF-12 生理成分评分在各时间点之间相当,但心理成分评分在翻修后下降。6 名患者在平均随访时间为 7.8 年(0.3 至 13.7 年)时接受了单侧再次翻修手术。以任何再次翻修为终点,Kaplan-Meier 生存概率在 13 年时为 85.3%。
接受 HRA 翻修的患者可以期望获得与初次手术后最佳功能和生活质量相当的结果,而再次翻修的风险较低。