McLaughlin Jeffrey R, Lee Kyla R, Johnson Mary Ann
Kennedy Center, Oshkosh, Wisconsin, USA.
Gundersen Health, Crosse, Wisconsin, USA.
Bone Jt Open. 2021 Jan 13;2(1):33-39. doi: 10.1302/2633-1462.21.BJO-2020-0157.R1. eCollection 2021 Jan.
We present the clinical and radiological results at a minimum follow-up of 20 years using a second-generation uncemented total hip arthroplasty (THA). These results are compared to our previously published results using a first-generation hip arthroplasty followed for 20 years.
A total of 62 uncemented THAs in 60 patients were performed between 1993 and 1994. The titanium femoral component used in all cases was a Taperloc with a reduced distal stem. The acetabular component was a fully porous coated threaded hemispheric titanium shell (T-Tap ST). The outcome of every femoral and acetabular component with regard to retention or revision was determined for all 62 THAs. Complete clinical follow-up at a minimum of 20 years was obtained on every living patient. Radiological follow-up was obtained on all but one.
Two femoral components (3.2%) required revision. One stem was revised secondary to a periprosthetic fracture one year postoperatively and one was revised for late sepsis. No femoral component was revised for aseptic loosening. Six acetabular components had required revision, five for aseptic loosening. One additional acetabular component was revised for sepsis. Radiologically, all femoral components remained well fixed. One acetabular was judged loose by radiological criteria. The mean Harris Hip Score improved from 46 points (30 to 67) preoperatively to 89 points (78 to 100) at final follow-up. With revision for aseptic loosening as the endpoint, survival of the acetabular component was 95% (95% confidence interval (CI) 90 to 98) at 25 years. Femoral component survival was 100%.
The most significant finding of this report was the low prevalence of aseptic loosening and revision of the femoral component at a mean follow-up of 22 years. A second important finding was the survival of over 90% of the hemispheric threaded ring acetabular components. While these shells remain controversial, in this series they performed well.Cite this article: 2021;2(1):33-39.
我们展示了使用第二代非骨水泥型全髋关节置换术（THA）至少随访20年的临床和放射学结果。将这些结果与我们之前发表的使用第一代髋关节置换术随访20年的结果进行比较。
1993年至1994年间，对60例患者进行了总共62例非骨水泥型THA手术。所有病例中使用的钛股骨部件是带有缩短远端柄的Taperloc。髋臼部件是一个全多孔涂层螺纹半球形钛壳（T-Tap ST）。确定了所有62例THA中每个股骨和髋臼部件的保留或翻修情况。对每位在世患者进行了至少20年的完整临床随访。除一名患者外，对所有患者都进行了放射学随访。
两个股骨部件（3.2%）需要翻修。一个柄在术后一年因假体周围骨折而翻修，另一个因晚期脓毒症而翻修。没有股骨部件因无菌性松动而翻修。六个髋臼部件需要翻修，五个是因无菌性松动。另外一个髋臼部件因脓毒症而翻修。放射学上，所有股骨部件保持良好固定。根据放射学标准，一个髋臼被判定为松动。平均Harris髋关节评分从术前的46分（30至67分）提高到最终随访时的89分（78至100分）。以无菌性松动翻修为终点，髋臼部件在25年时的生存率为95%（95%置信区间（CI）90至98）。股骨部件生存率为100%。
本报告最显著的发现是在平均随访22年时，股骨部件无菌性松动和翻修的发生率较低。第二个重要发现是超过90%的半球形螺纹环髋臼部件得以留存。虽然这些髋臼壳仍存在争议，但在本系列中它们表现良好。引用本文：2021；2(1):33 - 39。
