Malkani A L, Settecerri J J, Sim F H, Chao E Y, Wallrichs S L
Mayo Graduate School of Medicine, Rochester, Minnesota, USA.
J Bone Joint Surg Br. 1995 May;77(3):351-6.
We reviewed retrospectively 50 consecutive total hip arthroplasties with proximal femoral replacement prostheses in 49 patients. All the patients had massive bone loss. There were 31 women and 18 men who had undergone a mean of 3.1 hip operations. At the last review, 15 patients had died and two had been lost to follow-up, so that 32 patients (33 hips) were available for assessment. The mean age of the patients at the time of the operation was 60.6 years. The mean length of clinical follow-up was 11.1 +/- 4 years, and mean radiographic follow-up was 7.6 +/- 3.2 years. The average preoperative Harris hip score was 46 +/- 13 points, which improved to 80 +/- 10 points after one year and to 76 +/- 16 points at the latest follow-up. The most frequent complication was dislocation, which occurred in 11 hips. Four femoral components and seven acetabular prostheses were revised because of aseptic loosening. With revision at the end point, survivorship after total hip arthroplasty with a proximal femoral replacement prosthesis was predicted to be 64% at 12 years. Although our preliminary results of hip salvage with a proximal femoral replacement prosthesis were encouraging, a longer follow-up has shown a higher rate of failure.
我们回顾性分析了49例患者连续50例使用股骨近端置换假体的全髋关节置换术。所有患者均有大量骨质流失。其中31例女性和18例男性平均接受了3.1次髋关节手术。在最后一次随访时，15例患者死亡，2例失访，因此32例患者（33髋）可供评估。手术时患者的平均年龄为60.6岁。临床随访的平均时长为11.1±4年，影像学随访的平均时长为7.6±3.2年。术前Harris髋关节评分平均为46±13分，术后1年提高到80±10分，最近一次随访时为76±16分。最常见的并发症是脱位，11髋发生脱位。4个股骨组件和7个髋臼假体因无菌性松动而翻修。以翻修为终点，使用股骨近端置换假体的全髋关节置换术后12年的预计生存率为64%。尽管我们使用股骨近端置换假体挽救髋关节的初步结果令人鼓舞，但更长时间的随访显示失败率更高。
