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采用非骨水泥型股骨假体的全髋关节置换术。十年随访结果优异。

Total hip arthroplasty with an uncemented femoral component. Excellent results at ten-year follow-up.

作者信息

McLaughlin J R, Lee K R

机构信息

Kennedy Center for the Hip and Knee, Neenah, Wisconsin 54956-2792, USA.

出版信息

J Bone Joint Surg Br. 1997 Nov;79(6):900-7. doi: 10.1302/0301-620x.79b6.7482.

Abstract

We followed 138 patients (145 hips) who had had uncemented total hip arthroplasty using the Taperloc femoral component for a mean of ten years (8 to 12.5). No patient was lost to follow-up; 31 (31 hips) died before the minimum time of eight years for inclusion in the study, and 30 of these still had their femoral component in place. One well-fixed prosthesis had been exchanged at the time of acetabular revision. Of the remaining 114 hips, one femoral component required revision for aseptic loosening and one for sepsis. Three other well-fixed femoral components were removed during acetabular revision. Complete clinical and radiological follow-up was obtained in the 109 hips which had not had revision. Clinically, 94 (87%) were rated good or excellent, eight (7%) fair and seven (6%) poor. The average Harris hip score increased from 48 before operation to 88 at the time of the last follow-up. Radiologically, 103 hips (94%) had fixation by bone ingrowth, three (3%) showed stable fibrous ingrowth and three (3%) were unstable. Osteolysis of the fomoral cortex was seen in seven hips (6%), with major lysis in only one. At a mean follow-up of ten years, the results of the Taperloc femoral component are comparable with those of modern techniques of cementing in primary total hip arthroplasty.

摘要

我们对138例患者(145髋)进行了随访,这些患者均采用Taperloc股骨假体进行了非骨水泥型全髋关节置换术,平均随访时间为10年(8至12.5年)。无患者失访;31例(31髋)在纳入研究的最短8年随访期前死亡,其中30例的股骨假体仍在位。1例固定良好的假体在髋臼翻修时进行了更换。在其余114髋中,1例股骨假体因无菌性松动需要翻修,1例因感染需要翻修。在髋臼翻修时,另外3例固定良好的股骨假体被取出。对未进行翻修的109髋进行了完整的临床和影像学随访。临床上,94例(87%)评定为优或良,8例(7%)为中,7例(6%)为差。Harris髋关节平均评分从术前的48分提高到最后随访时的88分。影像学检查显示,103髋(94%)通过骨长入固定,3髋(3%)显示稳定的纤维长入,3髋(3%)不稳定。7髋(6%)出现股骨皮质骨溶解,仅1例有严重骨溶解。平均随访10年时,Taperloc股骨假体的结果与初次全髋关节置换术中现代骨水泥技术的结果相当。

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