Clement Nick David, Almeida Peter Richard, Patton James T, Wade Frazer, Goudie Ewan, Simpson Philip M S, Macpherson Gavin J, Gaston Paul
Edinburgh Orthopaedics, Edinburgh Royal Infirmary, Edinburgh, United Kingdom.
Arch Orthop Trauma Surg. 2025 Aug 19;145(1):411. doi: 10.1007/s00402-025-06034-0.
To assess the survival, complications, patient-reported outcomes and radiographic integration of the uncemented Trident II tritanium acetabular component when used for aseptic revision total hip arthroplasty (rTHA).
A single-centre prospective cohort study of 101 aseptic rTHA in 100 patients was undertaken. Inclusion criteria were patients suitable for the use of the uncemented acetabular component, aged 18-95 years, willing and able to comply with the study protocol, and provide informed consent. Those with inadequate bone stock to support fixation of the prosthesis were excluded. Functional assessments included the Oxford hip score, Forgotten joint score, EQ-5D, EQ-VAS, pain VAS and satisfaction. Radiographic assessment included acetabular lucent lines and lysis according to Delee and Charnley zones and loosening.
The mean age was 72.5 (standard deviation 11.6) and consisted of 54 females and 46 males. Mean follow-up was 3.1 (range 2 to 4.9) years during which 10 patients died. Indication for rTHA included: loosening of the acetabulum (n = 82), instability (n = 11), broken femoral stem (n = 3), metal on metal with pain and pseudotumour (n = 2), pain (n = 2) and loosening of femoral component (n = 1). There were two re-revisions for deep infection. This resulted in a 1-year all-cause survival of 99.0% (95% CI 97.1 to 100) and 4-year survival of 96.2% (95% CI 90.5 to 100). There was only one case with lucent lines in all three zones and had not osseointegrated, but the component remained stable at 3-years follow-up. All PROMs demonstrated a clinically meaningful improvement, which was significant (p < 0.001) at both 1- and 2-years. Patient satisfaction with their revision THA was 85.6% and 85.3% at 1- and 2-years.
The uncemented highly porous 3-dimensional printed Trident II tritanium acetabular component was associated with excellent survivorship, clinically meaningful improvements in PROMs, and high patient satisfaction in the short term when used for aseptic rTHA.
评估非骨水泥型Trident II三钛合金髋臼组件用于无菌性全髋关节翻修术（rTHA）时的生存率、并发症、患者报告结局及影像学融合情况。
对100例患者的101例无菌性rTHA进行单中心前瞻性队列研究。纳入标准为适合使用非骨水泥型髋臼组件、年龄在18 - 95岁、愿意并能够遵守研究方案且能提供知情同意书的患者。骨量不足以支持假体固定的患者被排除。功能评估包括牛津髋关节评分、遗忘关节评分、EQ - 5D、EQ - VAS、疼痛视觉模拟评分（VAS）及满意度。影像学评估包括根据Delee和Charnley分区的髋臼透亮线及骨溶解情况和松动情况。
平均年龄为72.5岁（标准差11.6），其中女性54例，男性46例。平均随访时间为3.1年（范围2至4.9年），期间10例患者死亡。rTHA的适应证包括：髋臼松动（n = 82）、不稳定（n = 11）、股骨干骨折（n = 3）、金属对金属伴疼痛和假肿瘤（n = 2）、疼痛（n = 2）及股骨组件松动（n = 1）。有2例因深部感染进行了再次翻修。这导致1年全因生存率为99.0%（95%可信区间97.1至100），4年生存率为96.2%（95%可信区间90.5至100）。所有三个分区均出现透亮线且未发生骨整合的仅有1例，但该组件在3年随访时仍保持稳定。所有患者报告结局指标均显示出具有临床意义的改善，在1年和2年时均具有显著性（p < 0.001）。患者对翻修全髋关节置换术的满意度在1年和2年时分别为85.6%和85.3%。
非骨水泥型高度多孔三维打印的Trident II三钛合金髋臼组件用于无菌性rTHA时，在短期内具有出色的生存率、患者报告结局指标的临床意义改善及较高的患者满意度。
