Taunton O D, Culpepper W J, Engh C A
Anderson Orthopaedic Research Institute, Alexandria, VA 22307, USA.
Clin Orthop Relat Res. 1997 Nov(344):150-61.
Five hundred eight consecutive cases (481 patients) treated with the extensively porous coated Anatomic Medullary Locking prosthesis were followed for an average of 9 years (range, 5-14 years). Thirty-one (6%) hips were lost to followup and 33 (7%) hips had complications that required revision surgery. The indications for revision were symptomatic stem loosening (six cases), symptomatic cup loosening (five cases), asymptomatic periarticular osteolysis (seven cases); trochanteric fracture through an osteolytic cyst (four cases), polyethylene fracture (five cases), sepsis (one case), and heterotopic ossification (one case). The surgical treatment of these complications is described. After these revisions, 11 (33%) cases had additional complications, most commonly a dislocation. Four required a second revision. Questionnaires and physical examinations were used to compare the outcome of the cases requiring revision with the outcome of those that did not. There were no differences in patient satisfaction between cases requiring revision surgery and those that did not (97% and 95% patient satisfaction, respectively). Function was also similar between the two groups, with 93% reporting increased function in each group.
对连续508例（481例患者）采用广泛多孔涂层解剖型髓内锁定假体进行治疗，并平均随访9年（范围5 - 14年）。31例（6%）髋关节失访，33例（7%）髋关节出现需要翻修手术的并发症。翻修的指征包括有症状的股骨柄松动（6例）、有症状的髋臼杯松动（5例）、无症状的关节周围骨溶解（7例）；经溶骨囊肿的转子骨折（4例）、聚乙烯磨损（5例）、感染（1例）和异位骨化（1例）。描述了这些并发症的手术治疗方法。在这些翻修手术后，11例（33%）出现了额外的并发症，最常见的是脱位。4例需要二次翻修。采用问卷调查和体格检查来比较需要翻修的病例与未翻修病例的结果。需要翻修手术的病例与未翻修病例之间的患者满意度无差异（分别为97%和95%的患者满意度）。两组之间的功能也相似，每组中93%的患者报告功能有所改善。
