Department of Orthopedics, Center for Joint Disease, Chonnam National University Hwasun Hospital, 322, Seo Yang-Ro, Hwasun-Eup, Hwasun-Gun, Jeonnam, 519-809, Republic of Korea.
J Orthop Surg Res. 2021 Mar 25;16(1):218. doi: 10.1186/s13018-021-02352-2.
Some propitious mid- and long-term studies had been reported for MoM bearings; however, most studies have addressed specific patient groups rather than younger, active patients, who probably represent the most suitable population for investigations on wear and osteolysis. The purpose of this study to evaluate the long-term results of second-generation metal-on-metal cementless total hip arthroplasty (THA) in patients aged <50 years.
From December 1997 to January 2004, primary THA using a metal-on-metal bearing cementless implant was performed in 63 patients (72 hips) aged <50 years. The mean follow-up duration was 18.6 (range, 15.9-22.1) years, and the mean age at initial operation was 39 (range, 22-49) years. Clinical results, complications, survivorship, osteolysis, and aseptic loosening were evaluated.
The mean Harris hip score and Western Ontario and McMaster Universities Arthritis Index scores were improved from 57.8 (range, 28-69) points and 73.4 (range, 63-94) points preoperatively to 91.7 (range, 80-100) points and 25.5 points (range, 17-38) points, respectively, at the last follow-up. Osteolysis lesions were found in 12 hips (acetabulum, 6 and femur, 6). The notching occurred on the femoral stem neck occurred in 12 hips. The mean serum cobalt and chromium concentrations were 2.3 (range, 0.2-10.6) μg/L and 1.7 (range, 0.4-8.1) μg/L, respectively, at a mean follow-up of 12.7 years in 32 patients (50.1%). The Kaplan-Meier survivorship curve analysis with revision for any reason as the endpoint revealed that 93.1% survived at 18.6 years' follow-up.
Second-generation metal-on-metal cementless THA was found to produce satisfactory clinical and radiographic results with a low revision rate for osteolysis and aseptic loosening in patients aged less than 50 years.
一些有利的中期和长期研究已经报道了 MoM 轴承; 然而，大多数研究都针对特定的患者群体，而不是年轻、活跃的患者，这些患者可能是最适合进行磨损和骨溶解研究的人群。本研究旨在评估第二代金属对金属无水泥固定全髋关节置换术（THA）在<50 岁患者中的长期结果。
1997 年 12 月至 2004 年 1 月，对 63 例<50 岁患者（72 髋）进行了金属对金属轴承无水泥植入物的初次 THA。平均随访时间为 18.6（范围，15.9-22.1）年，初次手术时的平均年龄为 39（范围，22-49）岁。评估临床结果、并发症、存活率、骨溶解和无菌性松动。
术前髋关节 Harris 评分和西安大略和麦克马斯特大学关节炎指数评分分别为 57.8（范围，28-69）分和 73.4（范围，63-94）分，末次随访时分别改善至 91.7（范围，80-100）分和 25.5 分（范围，17-38）分。12 髋（髋臼 6 髋，股骨 6 髋）发现骨溶解病变。12 髋股骨柄颈出现切迹。32 例患者（50.1%）平均随访 12.7 年后，血清钴和铬浓度分别为 2.3（范围，0.2-10.6）μg/L 和 1.7（范围，0.4-8.1）μg/L。Kaplan-Meier 生存曲线分析以任何原因的翻修为终点，结果显示 18.6 年随访时 93.1%的患者存活。
在<50 岁的患者中，第二代金属对金属无水泥固定 THA 具有令人满意的临床和影像学结果，且骨溶解和无菌性松动的翻修率较低。
