埃克塞特通用粘结型股骨假体

Exeter Universal cemented femoral component.

机构信息

Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK.

Department of Trauma and Orthopaedics, St Michael's Hospital, Toronto, Ontario, Canada.

出版信息

Bone Joint J. 2020 Oct;102-B(10):1319-1323. doi: 10.1302/0301-620X.102B10.BJJ-2019-1454.R1.

DOI:10.1302/0301-620X.102B10.BJJ-2019-1454.R1

PMID:32993348

Abstract

AIMS

We present the results, in terms of survival, clinical outcome, and radiological appearance at 20 years, in a cohort of 225 cemented Exeter Universal femoral components (Stryker, Newbury, UK) implanted in 207 patients, at a district general hospital.

METHODS

All patients in this study had a total hip arthroplasty (THA) using an Exeter Universal femoral component with a cemented (n = 215) or cementless (n = 10) acetabular component. Clinical and radiological data were collected prospectively at one year, five years, and every five years thereafter. Patients lost to radiological and clinical follow-up (five) were cross-referenced with National Joint Registry (NJR) data and general practitioner (GP) records to assess whether they had undergone revision for any reason.

RESULTS

During this period of study 144 patients (157 hips) died (69.78%). Two patients were lost to follow-up, leaving 61 patients (66 hips) available for review (29.33%). Of the 225 hips, three underwent revision for femoral failure with osteolysis. One underwent femoral component revision for treatment of a periprosthetic fracture. Eight underwent revision of the acetabular component only for loosening. Two hips had both components revised, when components were found to be loose at time of revision for acetabular loosening, though no radiological femoral osteolysis. Two patients underwent revision for infection. Using femoral loosening as an endpoint, the survival of the Exeter Universal femoral component was 98.7% (n = 220, 95% confidence interval (CI) 96.1% to 100%) at 20 to 22 years. Survival with an endpoint of revision for any reason was 92.6% (n = 209, 95% CI 89.4 to 95.55), with a 'worst-case scenario' (considering two patients lost to follow-up to have failed), the overall survival rate was 91.7% (n = 207, 95% CI 87.8 to 95.9) at 20 to 22 years.

CONCLUSION

Our results confirm excellent long-term results for the cemented Exeter Universal femoral componentimplanted outside of the originating centre. Cite this article: 2020;102-B(10):1319-1323.

摘要

目的

我们呈现了在一家地区综合医院，对 225 例使用固位型 Exeter 通用股骨柄（Stryker，Newbury，英国）的患者（207 例）20 年时的生存、临床结果和影像学表现，以此评估该结果。

方法

本研究中所有患者均接受了全髋关节置换术（THA），使用固位型 Exeter 通用股骨柄（n = 215）或非骨水泥型（n = 10）髋臼组件。在一年、五年和之后的每五年，临床和影像学数据均进行前瞻性收集。对（因死亡而）失去影像学和临床随访的 5 名患者（n = 5）进行了国家关节登记处（NJR）数据和全科医生（GP）记录的交叉参考，以评估他们是否因任何原因接受了翻修。

结果

在此研究期间，144 名患者（157 髋）死亡（69.78%）。2 名患者失访，61 名患者（66 髋）可进行复查（29.33%）。在 225 髋中，3 髋因股骨骨溶解而翻修。1 髋因假体周围骨折而翻修股骨组件。8 髋因髋臼组件松动而单独翻修。2 髋因髋臼组件松动，在翻修髋臼松动时发现股骨组件松动而同时翻修了股骨和髋臼组件。2 髋因感染而翻修。以股骨松动为终点， Exeter 通用股骨柄的生存情况为 20 至 22 年时的 98.7%（n = 220，95%置信区间（CI）96.1%至 100%）。以任何原因翻修为终点的生存情况为 92.6%（n = 209，95%CI 89.4 至 95.55%），考虑到 2 名失访患者已失败，总体生存率为 91.7%（n = 207，95%CI 87.8%至 95.9%），20 至 22 年时。