Sharp D J, Porter K M
Clin Orthop Relat Res. 1985 Dec(201):51-6.
Considering the high morbidity in young individuals, the authors reviewed 73 Charnley total hip arthroplasties in patients under age 40. The average follow-up period was 6.6 years. A total of 22 hips failed. Thirty-one hip arthroplasties were performed in normally ambulatory patients, with nine failures. Forty-two were performed in patients with limited locomotion, with 13 failures. The main cause of failure was loosening requiring revision (ten hips). There was radiologic evidence of progressive loosening in four other hips. Loss of trochanteric fixation required revision of six hips. Activity and rheumatoid disease were major contributing factors. Alternative methods of treatment should be considered in the young patient. When the operation is indicated, the greater trochanter must not be removed. It is hoped that cementless methods of fixation may produce a lower incidence of failure.
考虑到年轻个体中的高发病率，作者回顾了73例40岁以下患者接受Charnley全髋关节置换术的情况。平均随访期为6.6年。共有22例髋关节出现失败。31例髋关节置换术是在正常行走的患者中进行的，其中9例失败。42例是在行动受限的患者中进行的，有13例失败。失败的主要原因是松动需要翻修（10例髋关节）。另外4例髋关节有影像学证据显示渐进性松动。转子固定丢失需要对6例髋关节进行翻修。活动和类风湿疾病是主要的促成因素。对于年轻患者应考虑其他治疗方法。当需要进行手术时，大转子一定不能切除。希望非骨水泥固定方法可能会降低失败率。
