Department of Orthopedic Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
Clin Orthop Surg. 2022 Sep;14(3):335-343. doi: 10.4055/cios21176. Epub 2022 Mar 3.
The Harris-Galante (HG) prosthesis is a first-generation, cementless total hip arthroplasty (THA) prosthesis. Considering the recent increase in the demand for THA in young patients and their life expectancy, a study with a follow-up duration of longer than 20 years in a young population is needed. Therefore, we evaluated the long-term clinical and radiographic results after cementless THA using the HG prosthesis in patients younger than 50 years.
A total of 61 THAs performed using the HG with a minimum follow-up of 10 years were included. There were 38 men and 11 women with an average age of 46 years and the mean follow-up duration was 22 years. Clinical evaluation included modified Harris Hip Score (HHS) and radiographic analysis consisted of cup inclination, anteversion angle, component stability, osteolysis, liner wear rate, wear-through, liner dissociation, and heterotopic ossification. Complications included recurrent dislocation, periprosthetic femoral fracture, and periprosthetic joint infection. Survivorship analysis included cup and stem revision for aseptic loosening, as well as any revision.
The HHS improved from 46.5 preoperatively to 81.8 postoperatively ( < 0.001). The average linear wear rate was 0.36 mm/yr. A total of 34 hips (56%) were revised: stem revision in 10 (16.4%), cup revision in 9 (14.8%), exchange limited to bearing surface in 8 (13.1%), and revision of all components in 7 (11.5%). Estimated survivorship at 34 years postoperatively was 90.9% for cup revision for aseptic loosening, 80.5% for stem revision for aseptic loosening, and 22.1% for any revision.
THA using the HG prosthesis showed satisfactory estimated survivorship of the acetabular and femoral components at 34 years postoperatively with good clinical outcomes. Bearing-related problems, such as osteolysis and liner dissociation, accounted for 56% of revision operations and were concerns in patients younger than 50 years.
Harris-Galante（HG）假体是第一代非骨水泥全髋关节置换术（THA）假体。考虑到年轻患者对 THA 的需求以及他们的预期寿命最近有所增加，需要在年轻人群中进行随访时间超过 20 年的研究。因此，我们评估了在 50 岁以下患者中使用 HG 假体进行非骨水泥 THA 的长期临床和影像学结果。
共纳入 61 例采用 HG 假体进行的 THA，随访时间至少 10 年。其中男 38 例，女 11 例，平均年龄 46 岁，平均随访时间 22 年。临床评估包括改良 Harris 髋关节评分（HHS），影像学分析包括髋臼杯倾斜度、前倾角、假体稳定性、骨溶解、衬垫磨损率、衬垫穿透、衬垫分离和异位骨化。并发症包括复发性脱位、股骨假体周围骨折和假体周围关节感染。生存分析包括髋臼杯和股骨假体因无菌性松动而进行的翻修，以及任何其他翻修。
HHS 从术前的 46.5 分提高到术后的 81.8 分（<0.001）。平均线性磨损率为 0.36mm/年。共有 34 髋（56%）进行了翻修：10 髋（16.4%）进行了股骨假体翻修，9 髋（14.8%）进行了髋臼杯翻修，8 髋（13.1%）仅更换了关节面，7 髋（11.5%）进行了所有组件的翻修。术后 34 年，髋臼杯因无菌性松动而进行翻修的估计生存率为 90.9%，股骨假体因无菌性松动而进行翻修的估计生存率为 80.5%，任何原因进行翻修的估计生存率为 22.1%。
HG 假体 THA 在术后 34 年时，髋臼和股骨假体的估计生存率较高，临床结果良好。与轴承相关的问题，如骨溶解和衬垫分离，占翻修手术的 56%，是 50 岁以下患者的关注点。
