Berger R A, Kull L R, Rosenberg A G, Galante J O
Department of Orthopaedic Surgery, Rush-Presbyterian-St.-Luke's Medical Center, Chicago, IL, USA.
Clin Orthop Relat Res. 1996 Dec(333):134-46.
One hundred fifty consecutive hybrid total hip arthroplasties in 139 patients were performed using an uncemented hemispheric porous coated acetabular component (HGP-I) with screws and a femoral component (Precoat) cemented with contemporary cementing technique. The average patient age was 67 years (range, 39-85 years). No patients were lost to followup. Eighty-six patients (91 hips) were alive for an average clinical followup of 103 months (range, 84-127 months); 81 hips had corresponding radiographic analysis. The average Harris hip score preoperatively was 47 points and increased to 88 points at followup. Ninety-five percent of patients had absent or slight pain. Aseptic loosening occurred in 2 femoral components (1.3%), 1 of which was revised for secondary osteolysis. Both hips had suboptimal cement mantles (C-2 or D grades). No femoral osteolysis was seen in stable components. Two acetabular components migrated; 1 secondary to preoperative irradiation osteonecrosis and 1 secondary to a bulk autogenous graft. Acetabular osteolysis without loosening developed in 2 patients (1.3%). Using revision and radiographic loosening as the end point, the probability of both components surviving 10 years was 96.9%, 98.6% for the acetabular component, and 98.4% for the femoral component. These results show that hybrid total hip arthroplasty offers excellent clinical function and exceptional 10-year survivorship.
对139例患者连续实施了150例混合式全髋关节置换术，使用了带螺钉的非骨水泥半球形多孔涂层髋臼组件（HGP-I）以及采用当代骨水泥技术固定的股骨组件（Precoat）。患者平均年龄为67岁（范围39 - 85岁）。无患者失访。86例患者（91髋）存活，平均临床随访103个月（范围84 - 127个月）；81髋进行了相应的影像学分析。术前Harris髋关节评分平均为47分，随访时增至88分。95%的患者无疼痛或仅有轻微疼痛。2个股骨组件发生无菌性松动（1.3%），其中1例因继发性骨溶解而翻修。这两髋的骨水泥套均欠佳（C-2级或D级）。稳定组件未见股骨骨溶解。2个髋臼组件发生移位；1例继发于术前放疗后骨坏死，1例继发于大块自体骨移植。2例患者（1.3%）出现无松动的髋臼骨溶解。以翻修和影像学松动为终点，两个组件存活10年的概率为96.9%，髋臼组件为98.6%，股骨组件为98.4%。这些结果表明，混合式全髋关节置换术具有出色的临床功能和优异的10年生存率。
