The Joint Replacement Center, Seoul Metropolitan Government, SeoNam Hospital, 20, Shinjoung ipen1ro, Yangchun-Gu, Seoul, 08049, Republic of Korea.
Department of Orthopedic Surgery, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
Int Orthop. 2024 Dec;48(12):3127-3137. doi: 10.1007/s00264-024-06322-1. Epub 2024 Sep 21.
There is relatively little information on the long-term clinical results of patients aged < 50 years with a contemporary total hip arthroplasty (THA), although a high rate of revision is projected for this group. Therefore, the purpose of this study was to evaluate the long-term results (a minimum of 21 years) of a metaphyseal-engaging anatomic cementless total hip prosthesis in patients aged < 50 years at the time of their THA.
This study included 360 patients (498 hips), specifically 212 men and 148 women. The mean age of the patients at the time of their THA was 45.8 ± 8.1 years. The predominant diagnosis was osteonecrosis (56%). Demographic data, the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the University of California, Los Angeles (UCLA) activity score were recorded. Radiographic evaluation and dual-energy X-ray absorptiometry (DEXA) scanning were used to evaluate implant fixation, bone remodelling, and osteolysis. The mean follow-up was 25.2 year (range 21-28 years).
At the latest follow-up, the mean Harris hip, WOMAC, and UCLA activity scores were 93, 10, and 6.7 points, respectively. No patients had thigh pain. All hips had osseous integration of the acetabular and femoral components. No patient had grade 3 stress shielding. The 28-year survival rate was 98.2% (95% confidence interval [CI] 95-100%) for the acetabular components and 98.8% (95% CI 95-100%) for the femoral components. Overall, 90% of the patients were satisfied with the THA results.
The results suggest that a metaphyseal-engaging anatomic cementless femoral stem with alumina-on-alumina ceramic articulation provide outstanding long-term fixation and substantial pain relief well into the 3rd decade after surgery. Furthermore, there was no alumina ceramic fracture or osteolysis. Moreover, approximately 90% of the patients were satisfied with the results of their THA.
尽管预计该组的翻修率较高，但对于年龄<50 岁的接受现代全髋关节置换术（THA）的患者，其长期临床结果的信息相对较少。因此，本研究的目的是评估在接受 THA 时年龄<50 岁的患者使用一种骨水泥型假体的干骺端贴合解剖型非骨水泥全髋关节假体的长期结果（至少 21 年）。
本研究纳入了 360 名患者（498 髋），其中 212 名男性和 148 名女性。患者 THA 时的平均年龄为 45.8±8.1 岁。主要诊断为骨坏死（56%）。记录了人口统计学数据、Harris 髋关节评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及加利福尼亚大学洛杉矶分校（UCLA）活动评分。使用放射学评估和双能 X 线吸收法（DEXA）扫描来评估植入物固定、骨重塑和骨溶解。平均随访时间为 25.2 年（范围 21-28 年）。
在最近一次随访时，平均 Harris 髋关节评分、WOMAC 和 UCLA 活动评分分别为 93、10 和 6.7 分。无患者出现大腿疼痛。所有髋关节髋臼和股骨组件均有骨整合。无患者出现 3 级应力遮挡。髋臼组件的 28 年生存率为 98.2%（95%置信区间 [CI] 95-100%），股骨组件的生存率为 98.8%（95%CI 95-100%）。总体而言，90%的患者对 THA 结果感到满意。
结果表明，使用带氧化铝陶瓷关节的干骺端贴合解剖型非骨水泥股骨柄可提供出色的长期固定，并在术后的第三个十年中显著减轻疼痛。此外，未发生氧化铝陶瓷骨折或骨溶解。而且，大约 90%的患者对 THA 结果感到满意。
