JIS Orthopedics, New Albany, Ohio.
J Arthroplasty. 2023 Sep;38(9):1802-1807. doi: 10.1016/j.arth.2023.03.021. Epub 2023 Mar 15.
Previous studies have reported excellent results with tapered, titanium, porous plasma-sprayed components in patients undergoing uncemented primary total hip arthroplasty (THA). The purpose of this study was to examine survival and clinical results at a minimum 25-year follow-up.
We reviewed all patients who underwent primary THA at our center through 1995 with a specific femoral component that was essentially unchanged since its 1984 introduction, except porous coating was continued circumferentially in 1987, a hydroxyapatite-coated option was offered in 1988, and an offset option was added in 1999. There were 332 patients (396 THA) who had a minimum 25-year follow-up (range, 25 to 37). Mean age at surgery was 48 years (range, 21 to 70 years). Mean follow-up in nonfailed patients was 29 years (range, 25 to 37 years).
There were 31 femoral revisions (7.8%): 9 infections, 3 failures of ingrowth, 5 aseptic loosening, 8 osteolysis well-fixed, 2 periprosthetic fractures, 2 polyethylene wear with trochanteric avulsion, 1 component breakage, and 1 malalignment well-fixed. Kaplan-Meier survival with the endpoint of all-cause stem revision was 94.8% (95% confidence interval: ±0.9%) at 37 years, and with the endpoint of aseptic loosening/failure of ingrowth was 98.7% (95% confidence interval: ±0.5) at 37 years. Harris hip scores improved significantly from 43 preoperatively to 76 most recently.
This tapered, titanium, porous plasma spray-coated femoral component continues to demonstrate high long-term survival with a low rate of femoral component revision for any reason or aseptic loosening/failure of ingrowth.
之前的研究报告显示，在接受非骨水泥初次全髋关节置换术（THA）的患者中，使用锥形、钛制、多孔等离子喷涂部件可获得优异的效果。本研究旨在通过至少 25 年的随访来检验其生存率和临床结果。
我们回顾了 1995 年在我院行初次 THA 的所有患者，这些患者使用的股骨假体基本不变，自 1984 年首次应用以来，除了 1987 年开始环形多孔涂层、1988 年开始提供羟基磷灰石涂层、1999 年开始增加偏心距选项。共有 332 例患者（396 例 THA）获得了至少 25 年的随访（随访时间 25 至 37 年）。手术时的平均年龄为 48 岁（21 至 70 岁）。非失败患者的平均随访时间为 29 年（25 至 37 年）。
共有 31 例股骨翻修（7.8%）：9 例感染、3 例骨长入失败、5 例无菌性松动、8 例骨溶解固定良好、2 例假体周围骨折、2 例聚乙烯磨损伴大转子撕脱、1 例假体断裂、1 例对线不良固定良好。以全因假体翻修为终点的 Kaplan-Meier 生存率在 37 年时为 94.8%（95%置信区间：±0.9%），以无菌性松动/骨长入失败为终点的生存率为 98.7%（95%置信区间：±0.5）。Harris 髋关节评分从术前的 43 分显著提高至最近的 76 分。
这种锥形、钛制、多孔等离子喷涂涂层股骨假体在任何原因或无菌性松动/骨长入失败的情况下，其股骨假体翻修率均较低，长期生存率较高。
