Goldberg V M, Ninomiya J, Kelly G, Kraay M
Department of Orthopaedics, University Hospitals of Cleveland, Case Western University, OH 44106, USA.
Clin Orthop Relat Res. 1996 Dec(333):147-54.
A consecutive series of 125 hybrid total hip arthroplasties were performed in 120 patients by a single surgeon and were observed for an average of 8.6 years (range, 7-11 years). There were 38 men and 82 women with an average age of 71 years (range, 25-87 years) at the time of surgery. The diagnoses included primary and secondary osteoarthritis in 112 patients, osteonecrosis in 5 patients, and rheumatoid arthritis in 3 patients. All acetabular components were modular and had a Ti shell fixed with an average of 3 screws. The cemented femoral component was either Precoat or Precoat Plus with a 28-mm modular CoCr femoral head. The patients were prospectively observed clinically using the Harris hip score and radiographically using the Hip Society methods. Of the 125 total hip arthroplasties, 123 were followed for the entire observation period. The average preoperative Harris Hip Score was 37 (range, 15-55) and at the latest followup was 92 (range, 65-100). One acetabular component was revised for recurrent dislocations 3 years after surgery, and 1 stem was revised for mechanical loosening and 1 stem was radiographically loose. There was no evidence of cup migration of more than 1 mm. There were no radiolucencies around any of the screws. Two sockets had polyethylene wear of 2 mm. Localized pelvic osteolysis was noted in 5 hips (4%). The results of this study suggested that hybrid total hip replacement is an excellent procedure for reconstruction of the arthritic hip with minimal evidence of polyethylene wear and pelvic osteolysis.
一位外科医生对120例患者连续进行了125例混合式全髋关节置换术，并进行了平均8.6年（范围7 - 11年）的观察。手术时，男性38例，女性82例，平均年龄71岁（范围25 - 87岁）。诊断包括112例原发性和继发性骨关节炎、5例骨坏死以及3例类风湿关节炎。所有髋臼组件均为模块化，钛合金髋臼杯平均用3枚螺钉固定。骨水泥型股骨组件为Precoat或Precoat Plus，搭配28毫米模块化钴铬合金股骨头。采用Harris髋关节评分对患者进行前瞻性临床观察，并采用髋关节协会方法进行影像学观察。在125例全髋关节置换术中，123例完成了整个观察期。术前Harris髋关节评分平均为37分（范围15 - 55分），最新随访时为92分（范围65 - 100分）。1例髋臼组件在术后3年因复发性脱位进行了翻修，1例股骨柄因机械性松动进行了翻修，1例股骨柄影像学显示松动。没有证据表明髋臼杯移位超过1毫米。螺钉周围没有透亮区。2个髋臼杯的聚乙烯磨损为2毫米。5例髋关节（4%）出现局限性骨盆骨溶解。本研究结果表明，混合式全髋关节置换术是重建关节炎性髋关节的一种极佳手术方式，聚乙烯磨损和骨盆骨溶解迹象极少。
