Viglietta Edoardo, Fenucci Simone, Parisien Ariane, Tucker Andrew, Grammatopoulos George, Beaulé Paul E
Orthopaedic Unit, S. Andrea Hospital, University of Rome "La Sapienza" Rome, Italy.
The Ottawa Hospital Research Institute, Orthopaedic Research, Ottawa Ontario, Canada.
JB JS Open Access. 2025 Sep 19;10(3). doi: 10.2106/JBJS.OA.25.00180. eCollection 2025 Jul-Sep.
One of the most common causes of failure after metal-on-metal hip resurfacing (MoM HR) remains femoral neck fracture and aseptic loosening of the femoral component. The purpose of this study was to compare the survivorship of cemented and cementless femoral fixation metal on metal hip resurfacing.
Five-hundred ninety patients' MoM HR performed through the Hueter-anterior approach with a minimum 5-year (mean age 50 years, body mass index (BMI) 29, 555 men and 35 women) follow-up were reviewed. One hundred and forty-three cementless (mean age 50 years, mean BMI 29, 136 men and 7 women) and 143 cemented MoM HR (mean age 52 years, mean BMI 29, 136 men and 7 women) were matched on age, sex, and BMI. Overall failures, femoral failures, adverse events, and complications were assessed. Acetabular cup inclination, neck-shaft angle (NSA), stem-shaft angles (SSA), Δ NSA-SSA, and neck narrowing were recorded.
Survivorship was 91% at a mean follow-up of 8.2 years (range 5-19). There were 14 failures (10% rate) in the cemented group and 12 failures (8% failure rate) in the cementless group (p > 0.05) with men at 92.7% and women at 74.9% (p = 0.019). In the male group, using isolated femoral reasons for revision survivorship was 96.5% for the cemented group and 98% for the cementless group (p > 0.05). Neck narrowing more than 10% was present in 11 patients (8%) in the cemented group and in 3 patients (2%) in the cementless group (p < 0.01). No significant correlation was found between any radiological parameter and the risk of failure.
Both cementless and cemented MoM HR are associated with excellent survivorship, especially in men with cementless fixation having a lower incident of neck narrowing.
金属对金属髋关节表面置换术（MoM HR）后失败的最常见原因之一仍然是股骨颈骨折和股骨部件的无菌性松动。本研究的目的是比较骨水泥型和非骨水泥型股骨固定的金属对金属髋关节表面置换术的生存率。
回顾了590例通过休特前方入路进行MoM HR且随访至少5年（平均年龄50岁，体重指数（BMI）29，555例男性和35例女性）的患者。143例非骨水泥型（平均年龄50岁，平均BMI 29，136例男性和7例女性）和143例骨水泥型MoM HR（平均年龄52岁，平均BMI 29，136例男性和7例女性）在年龄、性别和BMI方面进行了匹配。评估了总体失败、股骨失败、不良事件和并发症。记录髋臼杯倾斜度、颈干角（NSA）、柄干角（SSA）、ΔNSA - SSA和颈部狭窄情况。
平均随访8.2年（范围5 - 19年）时生存率为91%。骨水泥组有14例失败（失败率10%），非骨水泥组有12例失败（失败率8%）（p > 0.05），男性为92.7%，女性为74.9%（p = 0.019）。在男性组中，因单纯股骨原因进行翻修的情况下，骨水泥组生存率为96.5%，非骨水泥组为98%（p > 0.05）。骨水泥组11例患者（8%）出现颈部狭窄超过10%，非骨水泥组3例患者（2%）出现（p < 0.01）。未发现任何放射学参数与失败风险之间存在显著相关性。
骨水泥型和非骨水泥型MoM HR均具有出色的生存率，尤其是非骨水泥固定的男性患者颈部狭窄发生率较低。
