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模块化双动在初次全髋关节置换中的至少 5 年结果。

Minimum Five-Year Outcomes of Modular Dual Mobility in Primary Total Hip Arthroplasty.

机构信息

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA.

出版信息

J Arthroplasty. 2022 Jul;37(7S):S566-S570. doi: 10.1016/j.arth.2022.02.118. Epub 2022 Mar 7.

Abstract

BACKGROUND

Using a modular dual-mobility (MDM) bearing in primary total hip arthroplasty (THA) has not been widely evaluated. The purpose of this study is to evaluate clinical outcomes and survivorship following MDM bearings in primary THA.

METHODS

We used our registry database for patients with an MDM bearing on primary THA, performed by 6 surgeons through supine direct lateral or direct anterior approach. MDM bearings were used most often when impingement or subluxation was present intraoperatively despite proper component position. Another indication was a patient with planned activities who might be at a higher risk of instability postoperatively.

RESULTS

A total of 127 MDM bearings were used in primary THA in 119 patients. Mean follow-up was 6.77 years (range 5-8.9). Five hips were revised, none of which were due to MDM bearing failure. Preoperative Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement, Veterans RAND/Short Form 12 Physical Health Score and Mental Health Score increased from 25.81 to 52.40 (P < .0001), 30.42 to 44.50 (P < .0001), and 36.21 to 52.70 (P < .0001) at latest completed survey follow-up, respectively.

CONCLUSION

This MDM bearing shows excellent functional outcomes at a minimum 5 years of follow-up with no bearing-related failures. It can be an excellent choice in primary THA specifically in females where the use of increased head size to prevent instability is not possible due to anatomical restrictions and liner thickness.

摘要

背景

在初次全髋关节置换术(THA)中使用模块化双动(MDM)轴承尚未得到广泛评估。本研究旨在评估初次 THA 中使用 MDM 轴承后的临床结果和生存率。

方法

我们使用了我们的登记数据库,其中包括接受初次 THA 且使用 MDM 轴承的患者,这些患者由 6 名外科医生通过仰卧位直接外侧或直接前入路进行手术。当术中存在撞击或半脱位且假体位置正确时,通常会使用 MDM 轴承。另一个适应证是计划进行活动的患者,他们术后可能有更高的不稳定风险。

结果

共有 119 名患者的 127 个 MDM 轴承被用于初次 THA。平均随访时间为 6.77 年(范围 5-8.9 年)。有 5 髋接受了翻修,没有一髋是由于 MDM 轴承故障。术前髋关节功能障碍和骨关节炎髋关节置换评分、退伍军人 RAND/短期 Form 12 健康评分(物理健康评分和心理健康评分)分别从 25.81 增加到 52.40(P<0.0001)、30.42 增加到 44.50(P<0.0001)和 36.21 增加到 52.70(P<0.0001)。

结论

在至少 5 年的随访中,这种 MDM 轴承显示出出色的功能结果,且无与轴承相关的失败。在初次 THA 中,它是一种出色的选择,特别是在女性中,由于解剖限制和衬垫厚度,无法使用更大的股骨头来预防不稳定。

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