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初次全髋关节置换术中L型杯状钛合金多孔涂层髋臼组件翻修风险高:至少14年随访

High Risk of Revision Associated with the L-Cup Titanium Alloy Porous Coated Acetabular Component in Primary Total Hip Arthroplasty: Minimum Follow-Up of 14 Years.

作者信息

Drobniewski Marek, Ruzik Kacper, Gonera Bartosz, Olewnik Łukasz, Borowski Adam, Triantafyllou George, Borowski Andrzej

机构信息

Clinic of Orthopaedic and Paediatric Orthopaedics, Medical University of Lodz, 90-419 Łódź, Poland.

Department of Clinical Anatomy, Masovian Academy in Płock, 09-402 Płock, Poland.

出版信息

J Clin Med. 2025 Feb 15;14(4):1301. doi: 10.3390/jcm14041301.

Abstract

Hip joint pain due to arthritis is a prevalent issue in adults, often necessitating surgical intervention such as total hip arthroplasty (THA). This procedure has been celebrated for its reliability; however, successful outcomes depend on numerous factors. Current advancements are focused on improving implant design and surgical methodologies. This study aimed to evaluate the long-term clinical and functional outcomes of uncemented total hip arthroplasty utilizing the L-Cup acetabular component. Between February 1999 and November 2010, 351 L-Cup components were implanted in 315 patients. A follow-up period ranged from 14 to 25 years. The clinical outcomes were assessed using the modified Merle d'Aubigné and Postel (MAP) classification and patient satisfaction was measured using a Visual Analog Scale (VAS). Postoperative evaluations showed significant improvement, with VAS scores decreasing from a mean of 7.2 to 2.1, indicating substantial pain alleviation. The modified MAP classification showed a significant improvement of 6.3 points throughout the follow-up period. The results revealed that 49.5% of the cases were classified as excellent, while 20.5% had poor outcomes due to prosthesis loosening. According to the Kaplan-Meier estimator, the 5-year survival rate for the acetabular component was 97.78%, with survival rates of 90.5% at 10 years, 80.45% at 15 years, and 73.79% at 20 years. Total hip arthroplasty is an effective treatment for advanced degenerative joint diseases. While significant postoperative improvements were documented, the observed prosthesis loosening in 20.5% of cases raises concerns about the long-term effectiveness of the L-Cup acetabular component and suggests the need for further refinement in surgical techniques and implant design.

摘要

因关节炎导致的髋关节疼痛在成年人中是一个普遍问题,常常需要诸如全髋关节置换术(THA)之类的手术干预。该手术因其可靠性而备受赞誉;然而,成功的结果取决于众多因素。当前的进展集中在改进植入物设计和手术方法上。本研究旨在评估使用L型髋臼组件的非骨水泥型全髋关节置换术的长期临床和功能结果。在1999年2月至2010年11月期间,315例患者植入了351个L型髋臼组件。随访期为14至25年。使用改良的Merle d'Aubigné和Postel(MAP)分类法评估临床结果,并使用视觉模拟量表(VAS)测量患者满意度。术后评估显示有显著改善,VAS评分从平均7.2降至2.1,表明疼痛得到大幅缓解。改良的MAP分类在整个随访期显示有6.3分的显著改善。结果显示,49.5%的病例被分类为优秀,而20.5%的病例因假体松动结果不佳。根据Kaplan-Meier估计器,髋臼组件的5年生存率为97.78%,10年生存率为90.5%,15年生存率为80.45%,20年生存率为73.79%。全髋关节置换术是治疗晚期退行性关节疾病的有效方法。虽然记录了术后的显著改善,但在20.5%的病例中观察到假体松动,这引发了对L型髋臼组件长期有效性的担忧,并表明需要进一步改进手术技术和植入物设计。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a21/11857016/3004efe901e5/jcm-14-01301-g001.jpg

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