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翻修手术治疗全髋关节置换术后召回患者不良局部组织反应的结果。

Outcome of revision surgery for adverse local tissue reactions in patients with recalled total hip arthroplasty.

机构信息

Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA.

出版信息

Arch Orthop Trauma Surg. 2022 Oct;142(10):2577-2583. doi: 10.1007/s00402-021-03891-3. Epub 2021 Apr 9.

Abstract

INTRODUCTION

Recalls of total hip arthroplasty (THA) implants, including metal-on-metal (MoM) THA and dual taper stems, due to increased risk of adverse local tissue reaction (ALTR), represent a challenge for both surgeons and patients. This study aims to analyze the revision surgery outcomes for ALTR in patients with recalled THA implants.

METHODS

A total of 118 consecutive patients who underwent revision surgery due to ALTR with recalled THA were analyzed. Sub-group analysis was performed for recalled MoM THAs, head-neck modular stems, and dual taper neck-stems.

RESULTS

At a mean follow-up of 6.6 years, the complication and reoperation rates of the recalled THAs were 32.2% and 25.4% respectively. The most common post-revision complication was dislocation (16%). Revision of modular taper corrosion THA and high-grade intraoperative tissue damage were risk factors associated with post-revision complications.

CONCLUSION

This study reports high complication and reoperation rates of recalled THAs at mid-term follow-up. The high revision surgery complication rates in both groups suggest the importance of a systematic evaluation of all THA patients with at-risk implants.

LEVEL OF EVIDENCE

Level III, case control retrospective analysis.

摘要

简介

由于金属对金属(MoM)全髋关节置换术(THA)和双锥度柄的不良局部组织反应(ALTR)风险增加,导致 THA 植入物召回,这对外科医生和患者都构成了挑战。本研究旨在分析因 THA 植入物召回而发生 ALTR 的患者行翻修手术的结果。

方法

分析了 118 例因 ALTR 行翻修手术的连续患者,这些患者均因 THA 植入物召回。对召回的 MoM THR、头颈模块柄和双锥度颈柄进行了亚组分析。

结果

在平均 6.6 年的随访中,召回 THA 的并发症和再次手术率分别为 32.2%和 25.4%。最常见的术后并发症是脱位(16%)。模块锥度腐蚀 THA 的翻修和术中组织损伤程度高是与术后并发症相关的危险因素。

结论

本研究报告了中期随访时召回 THA 的高并发症和再手术率。两组高翻修手术并发症发生率表明,对所有有风险植入物的 THA 患者进行系统评估非常重要。

证据等级

III 级,病例对照回顾性分析。

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