Yuen Jin Chuan, Pang Hee Nee, Woo Yew Lok, Lo Ngai Nung, Keng Jin Darren Tay, Chia Shi Lu, Yeo Seng Lin
Department of Orthopaedics, Hospital Tengku Ampuan Afzan, Kuantan, MYS.
Orthopedics, Singapore General Hospital, Singapore, SGP.
Cureus. 2023 Mar 11;15(3):e36029. doi: 10.7759/cureus.36029. eCollection 2023 Mar.
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.
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。