Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.
Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea.
J Bone Joint Surg Am. 2023 May 17;105(10):789-796. doi: 10.2106/JBJS.22.01291. Epub 2023 Mar 22.
We previously reported mid-term results of total hip arthroplasty (THA) using Delta ceramic-on-ceramic (CoC) bearings in 72 patients (86 hips) who were <30 years old. Noise was noted in 8 (9.3%) of the hips, no osteolysis or loosening was detected, and no patient required reoperation. The purpose of this study was to assess clinical and radiographic outcomes, complications, and survivorship at >10 years after THA using Delta CoC bearings in patients who were <30 years old.
Cementless THA with a Delta CoC bearing was performed between March 2008 and January 2012 in 91 hips of 76 patients who were <30 years old. Eighty-five hips in 71 patients (44 men and 27 women) with a mean age of 25.9 years (range, 16 to 29 years) at surgery were followed for a mean of 10.9 years (range, 10 to 13 years).
No ceramic bearings fractured. The incidence of squeaking increased to 5.9% (5 of 85), but the squeaking was not reproducible within individual patients. Periprosthetic osteolysis developed in 3 hips (3 patients): around the stem in 2 and around the metal shell in 1. The stem in 1 hip underwent revision because of a Vancouver type-B2 periprosthetic femoral fracture. One patient with systemic lupus erythematosus underwent irrigation and debridement for periprosthetic joint infection. Survivorship free of reoperation for any reason was 92.4% (95% confidence interval, 82.4% to 100%) at 13 years.
The long-term results and survivorship of Delta CoC THA in patients <30 years old were favorable.
Therapeutic Level II . See Instructions for Authors for a complete description of levels of evidence.
我们之前报道了 72 例（86 髋）年龄<30 岁的患者行全髋关节置换术（THA）使用 Delta 陶瓷-陶瓷（CoC）关节的中期结果。8 髋（9.3%）出现噪声，未发现骨溶解或松动，无患者需要再次手术。本研究旨在评估年龄<30 岁的患者行 Delta CoC 关节 THA 后>10 年的临床和影像学结果、并发症和生存率。
2008 年 3 月至 2012 年 1 月，对 76 例年龄<30 岁的患者的 91 髋行非骨水泥 THA 并使用 Delta CoC 关节。85 髋（71 例患者，44 名男性，27 名女性）获得随访，平均年龄 25.9 岁（1629 岁），平均随访 10.9 年（1013 年）。
无陶瓷关节发生断裂。异响发生率增加至 5.9%（5/85），但在单个患者中无法重现。3 髋（3 例患者）出现假体周围骨溶解：2 例发生在柄周围，1 例发生在金属壳周围。1 例患有系统性红斑狼疮的患者因温哥华 B2 型假体周围股骨骨折行翻修。1 例患者因假体周围关节感染行灌洗清创术。因任何原因行再次手术的生存率为 92.4%（95%置信区间，82.4%~100%），随访 13 年。
Delta CoC THA 治疗年龄<30 岁的患者长期结果和生存率良好。
治疗性 II 级。有关证据等级的完整说明，请参阅作者说明。
