Torisu T, Izumi H, Fujikawa Y, Masumi S
Department of Orthopaedic Surgery, Oita Medical University, Japan.
J Arthroplasty. 1995 Feb;10(1):15-27.
The authors report the clinical and radiographic results of 36 bipolar hip arthroplasties after performing excavation of the steep and shallow acetabulum without acetabular bone-grafting for dysplastic osteoarthritis. The procedures were carried out between 1981 and 1985. Survivorship analysis showed that 84.6 of the bipolar hip arthroplasties were retained for 8 years. Twenty-nine patients, which were followed for 6-9 years after surgery, were reviewed. Severity of acetabular dysplasia was classified according to the method of Crowe. Class 1 included 17 hips and class 2 included 12 hips. The average preoperative clinical score was 49 points. The average postoperative clinical hip score improved to 87 points after 6 years. Twenty-seven of the 29 hips assessed were classified as either excellent or good by Charnley's function score. Stress fracture, due to excessive acetabular excavation at the time of surgery, and femoral component loosening were major symptomatic complications. The cessation of radiographic evidence of migration of the bipolar socket was recognized in 25 of 29 procedures at 6 years after surgery (86.2%). Cineradiographic study demonstrated that the abduction motion under standing position for 20 of 24 hip joints functioned dominantly at the inner-bearing and metallic-stem interface.
作者报告了36例双极髋关节置换术的临床和影像学结果，这些手术是针对发育性骨关节炎患者，在未进行髋臼植骨的情况下对深浅不一的髋臼进行挖掘后实施的。手术于1981年至1985年期间进行。生存分析显示，84.6%的双极髋关节置换术假体保留了8年。对术后随访6 - 9年的29例患者进行了回顾。髋臼发育不良的严重程度根据Crowe方法进行分类。1级包括17个髋关节，2级包括12个髋关节。术前平均临床评分为49分。术后6年平均临床髋关节评分提高到87分。根据Charnley功能评分，29个评估髋关节中有27个被分类为优或良。手术时髋臼过度挖掘导致的应力性骨折以及股骨假体松动是主要的有症状并发症。术后6年，29例手术中有25例（86.2%）双极髋臼假体停止出现影像学上的移位证据。动态X线摄影研究表明，24个髋关节中有20个在站立位时的外展运动主要发生在内衬与金属柄界面。
