Böhm P, Bösche R
Orthopädische Universitätsklinik, Eberhard-Karls-Universität Tübingen, Germany.
J Bone Joint Surg Br. 1998 May;80(3):396-403. doi: 10.1302/0301-620x.80b3.8349.
We reviewed 264 consecutive primary total hip replacements in 244 patients in which the Harris-Galante I porous-coated acetabular component had been used. The mean follow-up was 95 months (69 to 132). In 221 arthroplasties a 32 mm ceramic head had been used, and in the other 43 one of cobalt-chrome alloy. There were 124 women and 120 men with a mean age at operation of 56.8 years (21 to 83). Survival analysis of the acetabular components was performed using the following definitions of failure: 1) infection; 2) removal because of aseptic loosening; 3) removal for any cause; and 4) a worst-case analysis including removal of the cup or infection or loss to follow-up. Two well-fixed cups had been removed because of deep infection and three, similarly sound cups had been exchanged at the time of femoral revision. None of the acetabular components had required revision for aseptic loosening. After 11 years survival was 97.7% using the worst-case criterion. Radiological analysis of 187 acetabular components at a mean of 82 months (41 to 132) revealed no case of aseptic loosening. Pelvic osteolysis was seen in only one patient, but was not progressive and showed signs of regression. The results using these acetabular components are encouraging but the need for regular follow-up remains since complications such as significant wear of the liner, massive osteolysis of the pelvis, aseptic loosening and late infection may increase in the second decade.
我们回顾了244例患者中连续进行的264例初次全髋关节置换术,这些手术均使用了Harris-Galante I型多孔涂层髋臼组件。平均随访时间为95个月(69至132个月)。在221例关节成形术中使用了32毫米陶瓷股骨头,在另外43例中使用了钴铬合金股骨头。患者中有124名女性和120名男性,平均手术年龄为56.8岁(21至83岁)。对髋臼组件进行生存分析时采用了以下失败定义:1)感染;2)因无菌性松动而取出;3)因任何原因取出;4)最坏情况分析,包括取出髋臼杯、感染或失访。有两个固定良好的髋臼杯因深部感染而被取出,另有三个同样完好的髋臼杯在股骨翻修时被更换。没有髋臼组件因无菌性松动而需要翻修。按照最坏情况标准,11年后的生存率为97.7%。对187个髋臼组件在平均82个月(41至132个月)时进行的放射学分析显示,没有无菌性松动的病例。仅在一名患者中发现骨盆骨质溶解,但没有进展,且有消退迹象。使用这些髋臼组件的结果令人鼓舞,但仍需要定期随访,因为在第二个十年中,诸如内衬严重磨损、骨盆大量骨质溶解、无菌性松动和晚期感染等并发症可能会增加。