Moran M C, Huo M H, Garvin K L, Pellicci P M, Salvati E A
Hospital for Special Surgery, New York Hospital-Cornell University Medical Center, New York.
Clin Orthop Relat Res. 1993 Sep(294):140-8.
Twenty-two arthroplasties were performed in 14 patients with sickle cell hemoglobinopathy (SCH). There were 15 primary and seven revision procedures; none were lost to follow-up evaluation. In the primary arthroplasty group, there were two deaths in patients whose implants were functioning well. The remaining 13 hips had a mean follow-up period of 4.8 years. Failure occurred in five of these 13 hips (38%), four due to aseptic acetabular loosening and one due to sepsis. In the revision arthroplasty group, at a mean follow-up period of 5.3 years, failure occurred in three hips (43%), one due to acetabular loosening, one due to femoral loosening, and one due to sepsis. Perioperative complication rates were high in both groups. Femoral intramedullary sclerosis and bone altered by marrow hyperplasia were associated with intraoperative technical difficulties as well as problems with achieving long-term component fixation. Though total hip arthroplasty provides the most reliable measure of effective treatment in SCH, it carries a high risk of complications and failure.
对14例镰状细胞血红蛋白病（SCH）患者实施了22例关节置换术。其中有15例初次手术和7例翻修手术；无一例失访。在初次关节置换术组中，有2例植入物功能良好的患者死亡。其余13髋的平均随访期为4.8年。这13髋中有5髋（38%）出现失败，4例因无菌性髋臼松动，1例因感染。在翻修关节置换术组中，平均随访期为5.3年，3髋（43%）出现失败，1例因髋臼松动，1例因股骨松动，1例因感染。两组的围手术期并发症发生率均较高。股骨髓内硬化和因骨髓增生而改变的骨质与术中技术困难以及实现长期假体固定的问题相关。虽然全髋关节置换术是SCH最可靠的有效治疗手段，但它具有较高的并发症和失败风险。
