Liu Wenlu, Lin Huanyi, Zeng Xianshang, Chen Meiji, Tang Weiwei, Zhou Ting, Yu Weiguang, Liu Qilong, Xu Guixing
Department of Rehabilitation Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, No. 26, Shengli Street, Jiang'an District, Wuhan, China.
Department of Urinary Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, China.
J Int Med Res. 2021 May;49(5):3000605211012210. doi: 10.1177/03000605211012210.
To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C).
Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter.
The mean follow-up was 84.12 (67-100) months for UTR and 84.23 (66-101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR).
In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.
比较在股骨颈骨折（AO/OTA：31B/C）患者中，初次金属对金属全髋关节置换术（MoM-TR）翻修为非骨水泥型全髋关节置换术（UTR）或骨水泥型全髋关节置换术（CTR）后的临床疗效。
回顾性分析2007年3月至2018年1月期间，因初次MoM-TR失败而进行234例UTR或CTR翻修手术的患者资料。在翻修术后3个月、6个月和12个月以及此后每12个月收集临床疗效数据，包括Harris髋关节评分（HHS）和主要骨科并发症。
UTR组的平均随访时间为84.12（67 - 100）个月，CTR组为84.23（66 - 101）个月。在最后一次随访时，CTR治疗的患者HHS评分优于UTR治疗的患者。在主要骨科并发症发生率方面也相应地发现了显著差异（CTR组为16.1%，UTR组为47.4%）。在再次翻修率（UTR组为10.3%，CTR组为2.5%）、假体松动率（UTR组为16.3%，CTR组为5.9%）和假体周围骨折率（UTR组为12.0%，CTR组为4.2%）等特定骨科并发症方面也检测到统计学上的显著差异。
在初次MoM-TR失败后的翻修情况下，CTR在改善功能结局和减少主要骨科并发症方面可能优于UTR。
