Baker Gavin, Hill Janet, O'Neill Francis, McChesney Jane, Stevenson Michael, Beverland David
Primary Joint Unit, Musgrave Park Hospital, Belfast, UK.
Bone Jt Open. 2024 Nov 5;5(11):971-976. doi: 10.1302/2633-1462.511.BJO-2024-0087.R1.
In 2015, we published the results of our ceramic-on-metal (CoM) total hip arthroplasties (THAs) performed between October 2007 and July 2009 with a mean follow-up of 34 months (23 to 45) and a revision rate of 3.1%. The aim of this paper is to present the longer-term outcomes.
A total of 264 patients were reviewed at a mean of 5.8 years (4.6 to 7.2) and 10.1 years (9.2 to 10.6) to determine revision rate, pain, outcome scores, radiological analysis, and blood ion levels. Those who were unwilling or unable to travel were contacted by telephone.
The all-cause revision rate at six years was 3.1% (eight THAs), increasing to 8.8% (18 THAs) at ten years. Of these, there were four and then seven bearing-related revisions at six and ten years, respectively. There was a statistically significant deterioration in the visual analogue scale pain score and Oxford Hip Score (OHS) between six and ten years. There were 18 CoM THAs in 17 patients who had a cobalt or chromium level over 4 ppb and ten CoM THAs in nine patients who had a cobalt or chromium level higher than 7 ppb with a statistically significant increase in chromium levels only between the two timepoints. Overall, 84 stems (39.1%) had significant radiolucent lines at ten years compared to 65 (25.5%) at six years.
When compared to the original review, there has been a significant deterioration in pain score, OHS, radiograph appearance, and, most critically, survival has fallen to 91.2%, which does not meet the Orthopaedic Data Evaluation Panel (ODEP) 10 A* 95% threshold. Although this bearing is no longer on the market, 2.5% were bearing-related revisions, which have relevance to the discussion around modular dual-mobility implants that have a similar metal interface.
2015年，我们公布了2007年10月至2009年7月期间进行的金属对陶瓷（CoM）全髋关节置换术（THA）的结果，平均随访34个月（23至45个月），翻修率为3.1%。本文的目的是呈现长期结果。
对总共264例患者进行了平均5.8年（4.6至7.2年）和10.1年（9.2至10.6年）的随访，以确定翻修率、疼痛情况、结果评分、影像学分析和血液离子水平。那些不愿意或无法前来的患者通过电话进行联系。
六年时的全因翻修率为3.1%（8例THA），十年时增至8.8%（18例THA）。其中，六年和十年时分别有4例和7例与假体相关的翻修。六年至十年间，视觉模拟量表疼痛评分和牛津髋关节评分（OHS）出现了具有统计学意义的恶化。17例患者中有18例CoM THA的钴或铬水平超过4 ppb，9例患者中有10例CoM THA的钴或铬水平高于7 ppb，仅在两个时间点之间铬水平有统计学意义的升高。总体而言，十年时84根股骨柄（39.1%）出现明显的透亮线，而六年时为65根（25.5%）。
与最初的评估相比，疼痛评分、OHS、X线片表现出现了显著恶化，最关键的是，生存率降至91.2%，未达到骨科数据评估小组（ODEP）10 A* 95%的阈值。尽管这种假体已不在市场上，但2.5%的翻修与假体相关，这与围绕具有类似金属界面的模块化双动式植入物的讨论相关。
