Callaghan J J, Forest E E, Sporer S M, Goetz D D, Johnston R C
Department of Orthopaedics, University of Iowa College of Medicine, Iowa City 52242, USA.
Clin Orthop Relat Res. 1997 Nov(344):257-62.
The durability of cemented and hybrid total hip arthroplasty in the young adult was evaluated. A consecutive series of primary cemented total hip arthroplasties performed between 1970 and 1976, and a consecutive series of primary hybrid total hip arthroplasties performed between 1986 and 1991, were evaluated for revision and radiographic loosening of the components. All patients were younger than 50 years of age at the time of surgery and all surgery was performed by one surgeon. At minimum 20 years followup of the cemented group (93 hips in 69 patients) 22% of hips (21 hips) were revised for aseptic loosening (5% of femoral components, five hips, and 19% of acetabular components, 18 hips). At 5- to 10-year followup of the hybrid group (45 hips in 37 patients) 18% of hips (eight hips) were revised for aseptic loosening (18% of femoral components, eight hips, and 0% of acetabular components, 0 hips). Although the cemented femoral component used in the hybrid series showed a marked increase in revision and loosening compared with the cemented series, the excellent fixation obtained with uncemented acetabular components has encouraged the authors to continue the use of hybrid fixation in the young adult. However, the femoral component has been modified to incorporate a polished surface finish and a stem geometry similar to the Charnley flat back prosthesis used in the cemented series.
对年轻成年人中骨水泥型和混合型全髋关节置换术的耐用性进行了评估。对1970年至1976年间连续进行的一系列初次骨水泥型全髋关节置换术，以及1986年至1991年间连续进行的一系列初次混合型全髋关节置换术，评估了假体的翻修情况和影像学松动情况。所有患者手术时年龄均小于50岁，且所有手术均由同一位外科医生完成。对骨水泥型组（69例患者的93髋）进行了至少20年的随访，22%的髋关节（21髋）因无菌性松动而翻修（股骨假体5%，5髋；髋臼假体19%，18髋）。对混合型组（37例患者的45髋）进行了5至10年的随访，18%的髋关节（8髋）因无菌性松动而翻修（股骨假体18%，8髋；髋臼假体0%，0髋）。尽管与骨水泥型系列相比，混合型系列中使用的骨水泥型股骨假体在翻修和松动方面显著增加，但非骨水泥型髋臼假体获得的良好固定效果促使作者继续在年轻成年人中使用混合型固定方式。然而，股骨假体已进行了改良，采用了抛光表面处理以及与骨水泥型系列中使用的Charnley平背假体相似的柄部几何形状。
