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无骨水泥髋关节翻修术的结果

Outcome of revision hip arthroplasty done without cement.

作者信息

Lawrence J M, Engh C A, Macalino G E, Lauro G R

机构信息

Anderson Orthopaedic Research Institute, Arlington, Virginia 22206.

出版信息

J Bone Joint Surg Am. 1994 Jul;76(7):965-73. doi: 10.2106/00004623-199407000-00002.

Abstract

Between 1980 and 1986, ninety-three femoral revision arthroplasties without cement were performed on ninety-one patients who had symptomatic loosening of a stemmed femoral component of a total hip prosthesis. Eighty-one of these patients (eighty-three hips) were followed for at least five years (range, five to thirteen years; mean, nine years). Forty-three hips also had a revision of a cemented acetabular component with use of a hemispherical, porous-coated implant inserted without cement. The results are presented in a traditional manner in terms of implant survivorship, radiographic evaluation for stability of the implant, and standardized hip scores. Changes due to the treatment are presented as outcomes in terms of the physician's criteria for the success of the operation, the patient's criteria for the success of the operation, and the patient's economic status. No hips that needed additional operations were excluded, and we reported the outcome regardless of any interim operative procedures (including re-revisions). At the latest follow-up examination, nineteen (23 per cent) of the eighty-three hips had had an additional operation, including seventeen hips (20 per cent) for which re-revision had been necessary. In ten (12 per cent) of the eighty-three hips, the re-revision had involved an index implant. The rate of re-revision of the index femoral component was 10 per cent and the rate of mechanical loosening of that component was 11 per cent. The rate of re-revision of the index acetabular component was 7 per cent and the rate of mechanical loosening of that component was 11 per cent.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

1980年至1986年间,对91例全髋关节假体股骨柄组件出现症状性松动的患者实施了93例非骨水泥型股骨翻修关节成形术。其中81例患者(83髋)接受了至少5年的随访(范围为5至13年;平均9年)。43髋还使用无骨水泥植入的半球形、多孔涂层髋臼组件进行了髋臼翻修。结果以传统方式呈现,包括植入物生存率、植入物稳定性的影像学评估以及标准化髋关节评分。根据医生对手术成功的标准、患者对手术成功的标准以及患者的经济状况,将治疗引起的变化作为结果呈现。未排除任何需要额外手术的髋关节,并且我们报告了所有结果,无论其间进行了任何手术操作(包括再次翻修)。在最近的随访检查中,83髋中有19髋(23%)接受了额外手术,其中17髋(20%)需要再次翻修。83髋中有10髋(12%)的再次翻修涉及初次植入物。初次股骨组件的再次翻修率为10%,该组件的机械性松动率为11%。初次髋臼组件的再次翻修率为7%,该组件的机械性松动率为11%。(摘要截短至250字)

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