Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
J Arthroplasty. 2022 Jul;37(7S):S582-S587. doi: 10.1016/j.arth.2022.01.090. Epub 2022 Feb 18.
Contemporary total hip arthroplasty (THA) often employs larger femoral heads to optimize hip stability. However, pairing 40-mm femoral heads with the smallest compatible acetabular components poses a potential risk for implant failure. The purpose of this study is to evaluate the outcomes of primary THAs using 40-mm femoral heads and the smallest compatible acetabular components.
Between 2007 and 2018, 177 primary THAs involving 40-mm femoral heads and acetabular components ≤56 mm with highly cross-linked polyethylene liners were identified. Mean age was 61 years, 56% were females, and mean body mass index was 32 kg/m. Cumulative incidences of dislocation, any revision, and any reoperation were determined utilizing a competing risk model. Osteolysis and femoral head penetration were assessed at minimum 8-year follow-up (n = 16). Mean follow-up was 6 years.
There were no cases of liner fractures or dissociations. The 10-year cumulative incidences of dislocation, any revision, and any reoperation were 3.6%, 4.2%, and 6.8%, respectively. Mean linear femoral head penetration was 0.01 mm/y and mean volumetric wear rate was 50 mm/y. One THA demonstrated stable, asymptomatic periacetabular radiolucent lines at most recent follow-up.
In 177 primary THAs pairing 40-mm femoral heads with the smallest compatible acetabular components, there were no liner fractures or dissociations. The cumulative incidence of dislocation was modest at 10 years. The cumulative incidences of any revision and any reoperation were low at mid-term.
IV.
当代全髋关节置换术（THA）常采用较大的股骨头来优化髋关节稳定性。然而，将 40mm 股骨头与最小匹配的髋臼组件搭配使用存在假体失败的潜在风险。本研究旨在评估使用 40mm 股骨头和最小匹配髋臼组件的初次 THA 的结果。
2007 年至 2018 年，共确定了 177 例涉及 40mm 股骨头和髋臼组件≤56mm 并采用高交联聚乙烯衬垫的初次 THA。平均年龄为 61 岁，56%为女性，平均体重指数为 32kg/m。利用竞争风险模型确定脱位、任何翻修和任何再次手术的累积发生率。在最低 8 年随访（n=16）时评估骨溶解和股骨头穿透情况。平均随访时间为 6 年。
无衬垫骨折或脱位。10 年的脱位、任何翻修和任何再次手术的累积发生率分别为 3.6%、4.2%和 6.8%。平均线性股骨头穿透率为 0.01mm/年，平均容积磨损率为 50mm/年。1 例 THA 在最近随访时显示稳定、无症状的髋臼周围透亮线。
在 177 例初次 THA 中，将 40mm 股骨头与最小匹配的髋臼组件搭配使用，无衬垫骨折或脱位。10 年时脱位的累积发生率适中。中期任何翻修和任何再次手术的累积发生率较低。
IV。
