Arthroplasty & Lower Extremity Reconstruction, Sunnybrook Holland Centre, Sunnybrook Health Sciences, University of Toronto, Toronto, Ontario, Canada.
Arthroplasty & Lower Extremity Reconstruction, Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences, Toronto, Ontario, Canada.
J Arthroplasty. 2021 Sep;36(9):3221-3225. doi: 10.1016/j.arth.2021.05.004. Epub 2021 May 20.
S-ROM hip is a well-established and versatile prosthesis that offers extensive metaphyseal and diaphyseal geometries providing solutions for a variety of surgical scenarios. The aim of this study is to report on long-term survivorship and radiographic outcomes of complex primary total hip arthroplasty (THA) using a modular cementless stem (S-ROM).
Retrospective consecutive study was conducted of 167 patients (167 hips): 97 males and 70 females with average age at the time of surgery of 55 years (range 22-76). All patients underwent complex THA by the senior author from 1987 to 1999. Patients were identified using a prospective database. Demographic, clinical, and surgical data were collected from health records. All patients received a cementless acetabular component with a standard polyethylene liner. The primary outcome measure was survivorship beyond 15 years using stem revision for any cause as an end point. Secondary outcome measure was rate of radiographic loosening using Engh classification.
Only 3 patients required stem revision for aseptic loosening and 1 for periprosthetic fracture. Isolated acetabular revision was undertaken in 23 of 167 patients (13.8%) due to polythene wear, osteolysis, and aseptic loosening. Proximal femoral stress shielding (zone 1, 7) was noted in 34 of 167 hips (20.4%). Stable bony ingrowth was noted in 144 hips (86.2%) and the remaining 23 hips had stable fibrous ingrowth (13.8%). Using stem "any-cause revision" as an endpoint, the mean stem survivorship was 31.5 years (95% confidence interval 31.007-31.985) with 30-year estimated survivorship of 97.6%.
In a single designer surgeon series, S-ROM stem has stood the test of time with long-term, 30-year survivorship of 97.6% and continues to play an important role in modern hip surgery providing longevity and versatility. However, further comparative long-term studies from independent centers are needed for a definitive conclusion.
IV.
S-ROM 髋关节是一种成熟且用途广泛的假体，它提供了广泛的近段和骨干几何形状，为各种手术情况提供了解决方案。本研究旨在报告使用模块化非骨水泥干骺端固定股骨柄（S-ROM）进行复杂初次全髋关节置换术（THA）的长期生存率和影像学结果。
回顾性连续研究了 167 例患者（167 髋）：97 例男性和 70 例女性，手术时平均年龄为 55 岁（范围 22-76 岁）。所有患者均由资深作者于 1987 年至 1999 年进行复杂 THA。使用前瞻性数据库确定患者。从病历中收集人口统计学、临床和手术数据。所有患者均接受了非骨水泥髋臼组件和标准聚乙烯衬垫。主要观察指标是采用任何原因的柄翻修为终点的 15 年以上生存率。次要观察指标是使用 Engh 分类的放射学松动率。
仅有 3 例患者因无菌性松动和 1 例患者因假体周围骨折需要翻修。由于聚乙烯磨损、骨溶解和无菌性松动，167 例患者中有 23 例（13.8%）需要单独进行髋臼翻修。167 髋中有 34 髋（20.4%）出现股骨近端应力遮挡（区 1，7）。144 髋（86.2%）出现稳定的骨长入，23 髋（13.8%）出现稳定的纤维长入。以“任何原因的柄翻修”为终点，平均柄生存率为 31.5 年（95%置信区间 31.007-31.985），30 年估计生存率为 97.6%。
在单一设计师医生系列中，S-ROM 柄经受住了时间的考验，具有长期的 30 年生存率为 97.6%，并继续在现代髋关节手术中发挥重要作用，提供了长久的使用寿命和多功能性。然而，还需要来自独立中心的进一步比较长期的研究来得出明确的结论。
IV。
