Service de Chirurgie Orthopédique, Clinique Maussins-Nollet, Ramsay Santé, Rue de Romainville 67, 75019, Paris, France.
Clinique Nollet, Rue Brochant 23, 75017, Paris, France.
Int Orthop. 2024 Dec;48(12):3091-3099. doi: 10.1007/s00264-024-06299-x. Epub 2024 Sep 27.
To report the prevalence of articular noise following total hip arthroplasty (THA) with custom stems and ceramic-on-ceramic (CoC) bearings, to determine the risk factors for articular noise, and the effect of articular noise on quality of life (QoL).
A consecutive series of uncemented primary THAs using custom stems implanted between 01/02/ 2014-01/04/2017 were evaluated. The cohort comprised 479 patients (529 hips, 301 males and 228 females), aged 55.9 ± 11.6 with a BMI of 25.8 ± 4.3 kg/m. Postoperative assessment included Oxford hip score (OHS), forgotten joint score (FJS), and a dedicated questionnaire on articular noise. Descriptive statistics were used to summarise the data. Regression analyses were performed to study factors associated with presence of noise.
At a minimum follow-up of five years, 431 patients (476 hips) were available for postoperative assessment. OHS was 45.3 ± 6.1, FJS was 83.6 ± 24.7, and 69 patients (71 hips, 15%) reported articular noise. The impact of noise on QoL was 1.4 ± 2.1. Multivariable analyses confirmed that the presence of articular noise was associated with younger age (OR,0.95; 95%CI,0.93-0.97; p < 0.001), smaller native femoral offset (OR, 0.95; 95%CI,0.90-1.00;p = 0.034), as well as intense (OR, 3.15; 95%CI, 1.15-9.79; p = 0.033) and very intense physical activity (OR, 4.71; 95%CI, 1.52-16.15; p = 0.009).
The prevalence of articular noise following primary THA with custom stems and CoC bearings was 15%, but the impact of noise on QoL was minimal for most patients. Younger, highly active patients should be advised of an increased likelihood of noise from CoC THA, particularly if they have low native femoral offset on preoperative imaging.
报告使用定制股骨柄和陶瓷对陶瓷（CoC）关节假体的全髋关节置换术（THA）后关节噪音的发生率，确定关节噪音的危险因素，以及关节噪音对生活质量（QoL）的影响。
连续评估了 2014 年 2 月 1 日至 2017 年 2 月 1 日期间使用定制股骨柄植入的未固定初次 THA 的连续病例系列。该队列包括 479 例患者（529 髋，301 例男性和 228 例女性），年龄 55.9±11.6 岁，BMI 为 25.8±4.3kg/m。术后评估包括牛津髋关节评分（OHS）、遗忘关节评分（FJS）和专门的关节噪音问卷。使用描述性统计数据总结数据。进行回归分析以研究与存在噪音相关的因素。
在至少 5 年的随访中，431 例患者（476 髋）可进行术后评估。OHS 为 45.3±6.1，FJS 为 83.6±24.7，69 例患者（71 髋，15%）报告有关节噪音。噪音对 QoL 的影响为 1.4±2.1。多变量分析证实，关节噪音的存在与年龄较小（OR，0.95；95%CI，0.93-0.97；p<0.001）、较小的股骨固有偏移量（OR，0.95；95%CI，0.90-1.00；p=0.034）以及剧烈（OR，3.15；95%CI，1.15-9.79；p=0.023）和非常剧烈的体力活动（OR，4.71；95%CI，1.52-16.15；p=0.009）相关。
使用定制股骨柄和 CoC 关节假体的初次 THA 后关节噪音的发生率为 15%，但大多数患者的噪音对 QoL 的影响很小。年轻、高度活跃的患者应被告知 CoC-THA 发生噪音的可能性增加，特别是如果他们在术前影像学检查中股骨固有偏移量较低。
