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髋关节置换术中关节表面置换(ASR)植入物的长期疗效:单机构回顾

Long-Term Outcomes of Articular Surface Replacement (ASR) Implant in Hip Arthroplasty: A Single Institution Review.

作者信息

Yuen Jin Chuan, Pang Hee Nee, Woo Yew Lok, Lo Ngai Nung, Keng Jin Darren Tay, Chia Shi Lu, Yeo Seng Lin

机构信息

Department of Orthopaedics, Hospital Tengku Ampuan Afzan, Kuantan, MYS.

Orthopedics, Singapore General Hospital, Singapore, SGP.

出版信息

Cureus. 2023 Mar 11;15(3):e36029. doi: 10.7759/cureus.36029. eCollection 2023 Mar.

DOI:10.7759/cureus.36029
PMID:36915400
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10008120/
Abstract

Various metal-on-metal (MoM) total hip replacements (THRs) have been found to have high short-term failure rates due to adverse responses to metal debris (ARMD). As a consequence, several low-performing THRs have been removed off the market. The purpose of this research was to look at the at least five-year outcomes of patients who had MoM hip arthroplasty at our institution. In one specialised centre between 2007 and 2008, 24 Articular Surface Replacement (ASR, DePuy, Warsaw, IN, USA) MoM THRs (in 24 patients, mean age: 56.4 years) were implanted. DePuy ASR hip prosthesis for osteoarthritis or hip fractures were employed in the THR system. All patients were summoned back for a clinical assessment, and imaging was done as needed. The average period of follow-up was 8.0 years (6.0-10 years). In all, eight instances (33.3%) were discovered to have pseudotumors, four hips (16.7%) were revised, and one (4.1%) was operated for ARMD. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Oxford ratings improved statistically significantly five years after surgery in all three areas of pain, disability, and stiffness; however, there was no statistically significant change in the 36-Item Short Form Survey (SF-36) (mental) score. MoM hip arthroplasty had a greater revision incidence at five years in our group, presumably owing to the adoption of a smaller femoral head size.

摘要

各种金属对金属(MoM)全髋关节置换术(THR)已被发现由于对金属碎屑的不良反应(ARMD)而具有较高的短期失败率。因此,几种性能不佳的THR已被撤出市场。本研究的目的是观察在我们机构接受MoM髋关节置换术的患者至少五年后的结果。在2007年至2008年期间,在一个专门中心为24例患者(平均年龄:56.4岁)植入了24个关节表面置换(ASR,DePuy,美国印第安纳州华沙)MoM THR。THR系统采用DePuy ASR髋关节假体治疗骨关节炎或髋部骨折。所有患者均被召回进行临床评估,并根据需要进行影像学检查。平均随访时间为8.0年(6.0 - 10年)。总共发现8例(33.3%)有假肿瘤,4髋(16.7%)进行了翻修,1例(4.1%)因ARMD进行了手术。西安大略和麦克马斯特大学关节炎指数(WOMAC)和牛津评分在术后五年时在疼痛、残疾和僵硬的所有三个方面均有统计学显著改善;然而,36项简短问卷调查(SF - 36)(心理)评分没有统计学显著变化。在我们的研究组中,MoM髋关节置换术在五年时的翻修发生率更高,可能是由于采用了较小的股骨头尺寸。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83f3/10008120/bfb9d44a9e12/cureus-0015-00000036029-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83f3/10008120/bfb9d44a9e12/cureus-0015-00000036029-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83f3/10008120/bfb9d44a9e12/cureus-0015-00000036029-i01.jpg

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本文引用的文献

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Setting benchmark revision rates for total hip replacement: analysis of registry evidence.设定全髋关节置换术的基准修订率:注册证据分析。
BMJ. 2015 Mar 9;350:h756. doi: 10.1136/bmj.h756.
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How safe are metal-on-metal hip implants?金属对金属髋关节植入物的安全性如何?
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Five-year results of the ASR XL Acetabular System and the ASR Hip Resurfacing System: an analysis from the Australian Orthopaedic Association National Joint Replacement Registry.ASR XL 髋臼系统和 ASR 髋关节表面置换系统的 5 年结果:来自澳大利亚矫形协会全国关节置换登记处的分析。
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Disappointing short-term results with the DePuy ASR XL metal-on-metal total hip arthroplasty.DePuy ASR XL 金属对金属全髋关节置换术令人失望的短期疗效。
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Cobalt toxicity--an emerging clinical problem in patients with metal-on-metal hip prostheses?钴中毒——金属对金属髋关节假体患者的一个新出现的临床问题?
Med J Aust. 2011 Jun 20;194(12):649-51. doi: 10.5694/j.1326-5377.2011.tb03151.x.
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Arthroprosthetic cobaltism: neurological and cardiac manifestations in two patients with metal-on-metal arthroplasty: a case report.人工关节置换钴中毒:两名金属对金属关节置换患者的神经和心脏表现:病例报告
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Metal-on-metal bearings total hip arthroplasty: the cobalt and chromium ions release concern.金属对金属髋关节置换术:钴和铬离子释放的担忧。
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Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement: A consequence of excess wear.髋关节表面置换和大直径全髋关节置换中金属对金属轴承的早期失效:过度磨损的后果。
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