Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Orthopedics, Nijmegen, The Netherlands.
Acta Orthop. 2023 Feb 28;94:102-106. doi: 10.2340/17453674.2023.9410.
Long-term follow-up of young patients following cemented primary THA is scarce. Therefore, we analyzed the survival of all consecutive primary THAs in patients under 25 years performed at our institute.
All primary THAs performed in patients younger than 25 years in our tertiary care institute between 1988 and 2015 were included (n = 119). Cemented fixation was used in all patients. In the case of acetabular bone deficiencies, reconstruction was performed using impaction bone grafting (IBG). We used Kaplan-Meier analysis to determine the survival of the primary THA with endpoints revision for any reason and aseptic loosening.
The mean age at the primary THA was 20 years. The most prevalent diagnosis was avascular necrosis (31%). The mean follow-up of the primary THA was 11 years (range 0-32). 2 patients (2 hips) were lost to follow-up. 16 revisions were registered. The survival of any component for endpoint revision for any reason was estimated at 92% (95% confidence interval [CI] 84-96) and 81% (CI 67-90) at 10- and 15-year follow-up, respectively. The survival of any component for endpoint revision for aseptic loosening was 99% (CI 93-100) and 88% (CI 71-95) at 10 and 15 years, respectively. 3 hips were revised due to infection.
Favorable long-term outcomes of primary THA in very young patients can be obtained using cemented fixation and IBG.
对接受骨水泥固定初次全髋关节置换术(THA)的年轻患者进行长期随访的研究较少。因此,我们分析了我院收治的所有年龄<25 岁的患者初次 THA 的生存情况。
我们纳入了我院在 1988 年至 2015 年间接受初次 THA 治疗的所有年龄<25 岁的患者(n=119)。所有患者均采用骨水泥固定。如果髋臼骨缺损,采用打压植骨(IBG)进行重建。我们采用 Kaplan-Meier 分析法来确定初次 THA 的生存情况,终点为任何原因的翻修和无菌性松动。
初次 THA 的平均年龄为 20 岁。最常见的诊断为股骨头坏死(31%)。初次 THA 的平均随访时间为 11 年(0-32 年)。2 例(2 髋)失访。共记录到 16 例翻修。任何组件因任何原因翻修的累计生存率估计为 92%(95%CI:84%-96%)和 81%(CI:67%-90%),分别在 10 年和 15 年随访时。任何组件因无菌性松动而翻修的累计生存率为 99%(95%CI:93%-100%)和 88%(CI:71%-95%),分别在 10 年和 15 年随访时。有 3 髋因感染而翻修。
对于年轻患者,采用骨水泥固定和 IBG 可获得满意的长期疗效。