Jayasinghe Gihan, Buckle Chris, Maling Lucy Clare, To Christopher, Anibueze Chukwudubem, Vinayakam Parthiban, Slack Richard
Trauma and Orthopaedics Department, Queen Elizabeth the Queen Mother Hospital, Margate, Kent, UK.
Arthroplast Today. 2021 Apr 5;8:181-187. doi: 10.1016/j.artd.2021.02.017. eCollection 2021 Apr.
The rate of revision hip arthroplasty surgery is rising. Surgeons must use implants with proven outcomes to help overcome the technical challenges faced during revision surgery. However, outcome studies using these implants are limited. The aim of this study is to investigate the radiographic and clinical outcomes of the Stryker Restoration stem, the most commonly used hip revision stem in the United Kingdom (UK).
A retrospective review of a single surgeon case series was performed. Immediate postoperative radiographs were analyzed for offset and leg length discrepancy. Radiographic evidence of subsidence was assessed using follow-up radiographs. Kaplan-Meier survival analysis was applied using explantation and reoperation as endpoints. Patient-reported outcomes were measured using the Oxford Hip Score and EQ-5D-5L.
One hundred ninety-eight cases were identified. Mean follow-up duration was 51.8 months (range: 24-121). Stem survival during this period was 98%. Reoperation for any reason was 13%. Mean subsidence was 4.18 mm. Analysis of variance testing showed no difference in mean subsidence between revision indications. Mean offset and leg length discrepancies were measured at 4.5 mm and 4.3 mm, respectively. The mean Oxford Hip Score for participants was 27.6.
This series demonstrates excellent implant survival, with radiographic parameters for reconstruction and subsidence levels comparable to those in the existing literature. The tapered modular hip revision stem provides surgeons with the intraoperative flexibility to overcome some of the anatomical difficulties encountered during revision surgery; this is reflected in the radiographic and clinical outcomes of the cohort in this study.
髋关节翻修手术的发生率正在上升。外科医生必须使用已证实有良好效果的植入物，以帮助克服翻修手术中面临的技术挑战。然而，使用这些植入物的疗效研究有限。本研究的目的是调查英国最常用的髋关节翻修柄——史赛克修复柄的影像学和临床疗效。
对单一外科医生的病例系列进行回顾性研究。分析术后即刻的X线片，测量偏移和肢体长度差异。使用随访X线片评估下沉的影像学证据。以取出植入物和再次手术为终点，应用Kaplan-Meier生存分析。使用牛津髋关节评分和EQ-5D-5L测量患者报告的结局。
共纳入198例病例。平均随访时间为51.8个月（范围：24 - 121个月）。在此期间柄的生存率为98%。因任何原因再次手术的比例为13%。平均下沉为4.18毫米。方差分析显示不同翻修指征之间的平均下沉无差异。平均偏移和肢体长度差异分别为4.5毫米和4.3毫米。参与者的平均牛津髋关节评分为27.6。
本系列研究显示植入物的生存率极佳，重建的影像学参数和下沉水平与现有文献相当。锥形模块化髋关节翻修柄为外科医生提供了术中灵活性，以克服翻修手术中遇到的一些解剖学困难；这在本研究队列的影像学和临床疗效中得到了体现。
