Research Department, Valdoltra Orthopaedic Hospital, Jadranska C. 31, 6280, Ankaran, Slovenia.
Department of Physical and Organic Chemistry, Jožef Stefan Institute, Jamova c. 39, 1000, Ljubljana, Slovenia.
Arch Orthop Trauma Surg. 2023 Oct;143(10):6021-6031. doi: 10.1007/s00402-023-04824-y. Epub 2023 Mar 16.
The main aim was to analyse the series of 29 collected cemented Charnley-Muller Alivium retrievals with the meantime in situ of 27 years. In addition, the revision rate of 1425 Alivium prostheses implanted at our institution between 1977 and 1992 was calculated.
The revision percentage of the Alivium cohort was calculated up to 45 years of follow-up and compared to that of all total hip arthroplasties (THAs) implanted in the same period (No. 5535). Metal and polyethylene retrieved components were inspected in 29 cases for wear damage and roughness. Wear particles were retrieved from periprosthetic tissue using digestion protocols and their composition, morphology, and size distribution were investigated. Periprosthetic tissue was analysed histologically.
The revision percentage of the Alivium cohort was 16% at 45 years of follow-up. It was comparable to all the THAs implanted at the same time (18%). The shape of polyethylene particles isolated from periprosthetic tissue corresponded to the wear pattern on polyethylene cups. Polyethylene particles were the main wear product, with the majority (68%) of particles smaller than 0.1 µm. Metal particles were rare with two types: CoCr and Cr based. Histological analysis showed that in 14 out of 18 specimens, the metal particles were graded + 1, reflecting that the metal loading in the periprosthetic tissue was low.
Our study represents valuable data not reported previously on the survival rate of Charnley-Muller prostheses at 45 years of follow-up and a unique insight into the collected retrievals from the materials' point of view.
本研究的主要目的是分析 29 例已回收的 Charnley-Muller Alivium 骨水泥型髋关节假体的系列结果，这些假体的原位时间为 27 年。此外，还计算了 1977 年至 1992 年期间在我院植入的 1425 例 Alivium 假体的翻修率。
计算了 Alivium 队列的翻修率，随访时间长达 45 年，并与同期植入的所有全髋关节置换术（THA）（No.5535）进行了比较。对 29 例金属和聚乙烯回收部件进行了磨损损伤和粗糙度检查。使用消化方案从假体周围组织中提取磨损颗粒，并对其成分、形态和尺寸分布进行了研究。对假体周围组织进行了组织学分析。
Alivium 队列的翻修率在 45 年的随访中为 16%，与同期植入的所有 THA 相似（18%）。从假体周围组织中分离出的聚乙烯颗粒的形状与聚乙烯杯的磨损模式相对应。聚乙烯颗粒是主要的磨损产物，其中 68%的颗粒小于 0.1μm。金属颗粒很少，有两种类型：CoCr 和 Cr 基。组织学分析显示，在 18 个标本中的 14 个标本中，金属颗粒的分级为+1，这反映了假体周围组织中的金属负荷较低。
本研究代表了之前未报道过的 Charnley-Muller 假体在 45 年随访时的生存率的有价值的数据，以及从材料角度对收集到的假体进行独特的分析。
