Wroblewski B M, Fleming P A, Hall R M, Siney P D
The John Charnley Research Institute, Wrightington Hospital for Joint Disease, Wigan, Lancashire, England, UK.
J Bone Joint Surg Br. 1998 Mar;80(2):273-8. doi: 10.1302/0301-620x.80b2.8042.
We report a prospective study of the use of intramedullary bone blocks to improve the fixation of a matt-finish femoral stem in Charnley low-friction arthroplasties. There were 379 patients (441 hips), but at a minimum follow-up of ten years there were 258 arthroplasties in 221 patients including some which had been revised. The mean age at surgery was 41 years (17 to 51) and the mean follow-up was 13.4 years (1 to 20 including the early revisions). Nine stems (3.5%) had been revised for aseptic loosening, but there were no stem fractures. Survivorship of stems was 99.2% at ten years and 94.35% at 15 and 20 years. We found that the patient's gender, the position of the stem and the experience of the surgeon all influenced the outcome. Our findings suggest that using our method of stem fixation, follow-up of over 11 years was needed to reveal the effects of endosteal cavitation of the femur, and of over 13 years to assess any divergence between the clinical and the radiological outcomes of stem fixation.
我们报告了一项关于使用髓内骨块来改善Charnley低摩擦人工关节置换术中磨砂表面股骨柄固定效果的前瞻性研究。共有379例患者（441髋），但在至少十年的随访后，221例患者中有258例人工关节置换术，其中包括一些进行了翻修的病例。手术时的平均年龄为41岁（17至51岁），平均随访时间为13.4年（1至20年，包括早期翻修病例）。9个股骨柄（3.5%）因无菌性松动而进行了翻修，但未发生股骨柄骨折。股骨柄在十年时的生存率为99.2%，在15年和20年时为94.35%。我们发现患者的性别、股骨柄的位置以及外科医生的经验均会影响结果。我们的研究结果表明，采用我们的股骨柄固定方法，需要超过11年的随访来揭示股骨骨内膜空泡化的影响，超过13年的随访来评估股骨柄固定的临床和放射学结果之间的差异。
