Shih C H, Ho W B
Clin Orthop Relat Res. 1985 Mar(193):141-5.
Noncemented autophor ceramic total hip arthroplasty (ACTHA) has been developed in recent years for treatment of advanced hip diseases. Bilateral ACTHAs were routinely performed in two operations at a four- to six-month interval. There have been no reported series of one-stage bilateral ACTHAs. In this retrospective study, the authors compared 20 patients who had bilateral one-stage ACTHAs with 15 patients who had similar bilateral arthroplasties in two stages. The study revealed no significant differences in estimated intraoperative blood loss, postoperative hemovac drainage, total amount of blood transfusion, intra- or postoperative complications, or postoperative functional results in the two groups. There was no difference in achieving prosthesis stability by interface bone growth, in spite of a significant difference in weight-bearing status during the immediate postoperative period. The one-stage bilateral procedure, however, offered advantages over two-stage bilateral procedures, including shorter length of hospital stay (18 days versus 27 days), shorter operative time (148 minutes versus 245 minutes), shorter period of disability (86 days versus 202 days), and reduced economic costs (about 10% less). There was no increase in the risk of morbidity or mortality in the one-stage bilateral group. In selected cases, one-stage bilateral ACTHA would be preferable.
近年来，非骨水泥型自体陶瓷全髋关节置换术（ACTHA）已被开发用于治疗晚期髋关节疾病。双侧ACTHA通常分两次手术进行，间隔四到六个月。目前尚无关于一期双侧ACTHA的系列报道。在这项回顾性研究中，作者将20例行一期双侧ACTHA的患者与15例行类似双侧关节置换术分两期进行的患者进行了比较。研究显示，两组在估计术中失血量、术后负压引流、输血总量、术中和术后并发症或术后功能结果方面无显著差异。尽管术后即刻负重状态存在显著差异，但两组通过界面骨生长实现假体稳定性方面并无差异。然而，一期双侧手术比两期双侧手术具有优势，包括住院时间缩短（18天对27天）、手术时间缩短（148分钟对245分钟）、残疾时间缩短（86天对202天）以及经济成本降低（约低10%）。一期双侧组的发病或死亡风险没有增加。在某些选定的病例中，一期双侧ACTHA更为可取。
