Clinica Ortopedica E Traumatologica, Ospedale Policlinico San Martino, Genova, Italy.
Ospedale Santa Corona, Pietra Ligure (SV), Italy.
Eur J Orthop Surg Traumatol. 2021 Oct;31(7):1515-1521. doi: 10.1007/s00590-021-02917-1. Epub 2021 Mar 3.
Total hip arthroplasties (THAs) are rising worldwide, as the functional request of patients who undergo this procedure. The trabeculae oriented pattern (TOP) is a modern cup, which follows the philosophy of the tissue sparing surgery (TSS). Focusing on clinical and radiological results and complications, the authors aim to highlight the outcomes of the TOP at a long-term follow-up (FU).
A retrospective analysis was completed on THA performed with the TOP cup between 1997 and 2015. Five hundred and eighty-eight patients sustained surgery, for a total of 662 cup implanted. Four hundred and sixty patients (524 hips) were examined. Mean FU was 12 ± 4.9 years (range 5-22). Clinical (HHS, OHS and VAS) and radiological data were obtained. Every complication, reoperation or revision was recorded and analyzed.
Clinical evaluation revealed a HHS of 87.1 ± 13.8 an OHS of 41.3 ± 5.4, and a VAS of 1.2 ± 1.1. Acetabular osteolysis was observed in 53 hips. Overall survival rate of the cup was 90.5% (50 revisions), the main causes of cup substitution being aseptic loosening (AL) of the cup combined with the stem (26), of the cup only (13 cases) and periprosthetic joint infection (7 cases).
TOP cup has demonstrated a good overall survivorship at a long-term FU, even compared with other coated cups, providing excellent clinical result with low rate of complications. Its association with a neck sparing stem permits a physiologic load transmission, reducing the stress shielding effect that could cause early implant mobilization.
随着接受全髋关节置换术（THA）患者的功能需求不断提高，全球范围内 THA 的数量不断增加。骨小梁定向模式（TOP）是一种现代的髋臼杯，遵循组织保留手术（TSS）的理念。本文重点关注临床和影像学结果以及并发症，旨在长期随访（FU）中强调 TOP 的结果。
对 1997 年至 2015 年间使用 TOP 髋臼杯进行的 THA 进行回顾性分析。共有 588 例患者接受了手术，共植入 662 个髋臼杯。对 460 例患者（524 髋）进行了检查。平均 FU 为 12±4.9 年（范围 5-22 年）。获得了临床（HHS、OHS 和 VAS）和影像学数据。记录并分析了每种并发症、再次手术或翻修。
临床评估显示 HHS 为 87.1±13.8，OHS 为 41.3±5.4，VAS 为 1.2±1.1。53 髋出现髋臼骨溶解。髋臼杯的总体生存率为 90.5%（50 例翻修），杯置换的主要原因是髋臼杯和柄的无菌性松动（AL）（26 例）、仅髋臼杯（13 例）和假体周围关节感染（7 例）。
在长期 FU 中，TOP 髋臼杯表现出良好的总体生存率，即使与其他涂层髋臼杯相比，也能提供出色的临床结果，且并发症发生率低。它与保留颈的柄结合使用，可以实现生理性的负荷传递，减少可能导致早期植入物松动的应力遮挡效应。
