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金属对金属全髋关节翻修术失败后采用骨水泥型假体翻修:157 例连续患者的平均 10 年随访结果。

Revision of failed metal-on-metal total hip arthroplasty using cemented arthroplasty: a mean 10-year follow-up of 157 consecutive patients.

机构信息

Department of Orthopaedics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Int Med Res. 2021 Jan;49(1):300060520969478. doi: 10.1177/0300060520969478.

Abstract

OBJECTIVE

This study was performed to assess the outcomes of Asian patients who underwent conversion from metal-on-metal total hip arthroplasty (MoM-THA) to cemented THA (CTHA).

METHODS

One hundred and fifty-seven consecutive patients (157 hips) who underwent CTHA following primary MoM-THA from January 2005 to February 2015 were retrospectively analysed. The primary endpoints were the clinical outcomes. Follow-ups occurred at 3 months, 6 months, 1 year, 2 years, and then every 2 years following revision of MoM-THA.

RESULTS

The mean follow-up after conversion was 10 years (range, 5-14 years). Statistically significant improvements in the mean Harris hip score were observed between the preoperative and final follow-up evaluations (62.71 ± 13.85 vs. 84.03 ± 16.21, respectively). The major orthopaedic complication rate was 16.5% (26/157). Six (3.8%) patients underwent revision at a mean of 3.5 ± 1.3 years after conversion, predominantly because of prosthesis loosening or recurrent dislocation. Nine (5.7%) patients developed prosthesis loosening at a mean of 2.6 ± 1.1 years following conversion, two of whom requested revision surgery. Eleven (7.0%) patients developed prosthesis dislocation, four of whom requested revision surgery.

CONCLUSION

CTHA may yield favourable functional outcomes and a reduced rate of major orthopaedic complications.

摘要

目的

本研究旨在评估行金属对金属全髋关节置换术(MoM-THA)翻修为骨水泥型全髋关节置换术(CTHA)的亚洲患者的结局。

方法

回顾性分析 2005 年 1 月至 2015 年 2 月期间因初次 MoM-THA 后行 CTHA 的 157 例连续患者(157 髋)。主要终点为临床结果。随访时间为 MoM-THA 翻修后 3 个月、6 个月、1 年、2 年,此后每 2 年随访一次。

结果

转换后的平均随访时间为 10 年(5-14 年)。术前和最终随访时的平均 Harris 髋关节评分均有显著改善(分别为 62.71±13.85 分和 84.03±16.21 分)。主要骨科并发症发生率为 16.5%(26/157)。6 例(3.8%)患者在转换后平均 3.5±1.3 年接受了翻修手术,主要原因是假体松动或复发性脱位。9 例(5.7%)患者在转换后平均 2.6±1.1 年发生假体松动,其中 2 例要求翻修手术。11 例(7.0%)患者发生假体脱位,其中 4 例要求翻修手术。

结论

CTHA 可能获得良好的功能结果和降低主要骨科并发症的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9eae/7809321/b195ed87ea5f/10.1177_0300060520969478-fig1.jpg

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