Bert J M
Landmark Orthopedics, St, Paul, MN 55102, USA.
J Arthroplasty. 1996 Dec;11(8):905-15. doi: 10.1016/s0883-5403(96)80131-8.
Custom total hip arthroplasty (THA) has been advocated as a primary operation to achieve optimal proximal fit and fill in THA. Because of the increased cost of the implant, it must be proved that survivorship of the custom component is improved compared with a well-cemented or cementless off-the-shelf femoral prosthesis. A series of 64 primary and revision femoral component custom titanium uncemented THAs were reviewed. In the primary custom group 90.9%, and in the revision group 80%, had good to excellent results using the Harris hip scoring system at a mean follow-up period of 6.5 years. The age range was 32 to 74 years (mean, 53 years). Thigh pain was present in 17% of the patients in this series. Significant osteolysis occurred in 4.7% of the cases. The average time to failure for the four primary custom THAs was 4.1 years, and for the four revision custom THAs, 2.4 years. Despite excellent proximal fit and fill, these short-term results have not resulted in improved success rates compared with a well-cemented or cementless off-the-shelf femoral component when performing THA.
定制全髋关节置换术（THA）已被提倡作为一种主要手术方式，以在THA中实现最佳的近端贴合和填充。由于植入物成本增加，必须证明与使用良好的骨水泥型或非骨水泥型现成股骨假体相比，定制组件的生存率有所提高。回顾了一系列64例初次和翻修股骨组件定制钛合金非骨水泥型THA。在初次定制组中，使用Harris髋关节评分系统，在平均随访6.5年时，90.9%的患者结果为良好至优秀；在翻修组中，这一比例为80%。年龄范围为32至74岁（平均53岁）。该系列中17%的患者存在大腿疼痛。4.7%的病例发生了明显的骨溶解。4例初次定制THA的平均失败时间为4.1年，4例翻修定制THA的平均失败时间为2.4年。尽管近端贴合和填充效果极佳，但在进行THA时，与使用良好的骨水泥型或非骨水泥型现成股骨组件相比，这些短期结果并未带来更高的成功率。
