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45岁及以下患者骨水泥型全髋关节置换术的长期结果:一项16年的随访研究

Long-term results of cemented total hip arthroplasty in patients 45 years old or younger. A 16-year follow-up study.

作者信息

Dorr L D, Kane T J, Conaty J P

机构信息

University of Southern California Center for Arthritis and Joint Implant Surgery, University of Southern California University Hospital, Los Angeles.

出版信息

J Arthroplasty. 1994 Oct;9(5):453-6. doi: 10.1016/0883-5403(94)90090-6.

Abstract

Forty-nine cemented total hip arthroplasties in patients younger than 45 years were reviewed, with an average follow-up period of 16.2 years. The results were compared with the same group previously reported at average follow-up periods of 4.5 and 9.2 years. Clinically satisfactory results were 27% at 16.2 years compared with 78% at 4.5 years and 58% at 9.2 years. The revision rate increased from 12% at 4.5 years to 33% at 9.2 years to 67% in this study. The revision rate for patients younger than 30 at the time of the index arthroplasty was 82% compared with 56% for those over 30. Impending failure was present in 81% of the 16 unrevised hips compared with 56% at 9.2 years and 29% at 4.5 years. Patients younger than 30, in Charnley category A or B, and with a diagnosis of osteonecrosis or osteoarthritis had the poorest clinical results. As in the previous two studies, the best results were obtained in category C patients who were over 30 years of age with inflammatory collagen disease. The purpose of this study is to report the long-term (average, 16.2 years) follow-up results of patients under the age of 45 who underwent cemented total hip arthroplasty at Rancho Los Amigos Medical Center between 1972 and 1978. The 4.5-year and 9.2-year results form the basis for comparison.

摘要

对49例年龄小于45岁的骨水泥型全髋关节置换术患者进行了回顾性研究,平均随访期为16.2年。将结果与之前报道的同一组患者在平均随访期4.5年和9.2年时的情况进行了比较。16.2年时临床满意度为27%,而4.5年时为78%,9.2年时为58%。本研究中翻修率从4.5年时的12%增至9.2年时的33%,再到67%。初次置换术时年龄小于30岁患者的翻修率为82%,而30岁以上患者为56%。16例未翻修髋关节中有81%存在即将失败的情况,相比之下,9.2年时为56%,4.5年时为29%。年龄小于30岁、Charnley分级为A或B级且诊断为骨坏死或骨关节炎的患者临床结果最差。与前两项研究一样,30岁以上患有炎性胶原病的C级患者取得了最佳结果。本研究的目的是报告1972年至1978年间在兰乔·洛斯阿米戈斯医疗中心接受骨水泥型全髋关节置换术的45岁以下患者的长期(平均16.2年)随访结果。4.5年和9.2年的结果作为比较的基础。

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