Early Failure of Articular Surface Replacement XL Total Hip Arthroplasty
Early Failure of Articular Surface Replacement XL Total Hip Arthroplasty
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DOI：
10.1016/j.arth.2011.03.027
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发表时间：
2011-09-01
影响因子：
3.5
通讯作者：
Nadaud, Matthew C.
中科院分区：
文献类型：
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作者：
Steele, Garen D.;Fehring, Thomas K.;Nadaud, Matthew C.
ASR(关节表面置换)XL(DePuy，Warsaw，Ind)金属对金属髋关节置换术具有稳定性和增加活动度的优点。然而，早期失败的数量惊人，促使对使用该系统治疗的患者进行评估。对使用ASR XL系统进行关节置换术的患者进行了前瞻性研究。有2年随访或任何翻修的患者都包括在内。失败率、安大略省西部大学和麦克马斯特大学骨关节炎指数(WOMAC)评分和X光片被评估。纳入95例患者(105个髋关节)。共进行了16次修订。13例(12%)为无菌髋臼衰竭。其中8例为无菌性松动，4例为金属化，1例为错位，2例为感染，1例为假体周围骨折。平均翻修时间为1.6年(0.18~3.4年)。ASR XL的翻修率为12%，是第二个报道的1件金属对金属系统，在早期随访时有显著的失败率。这种特殊类型的植入物存在固有的设计缺陷，会导致早期失败。
The ASR (articular surface replacement) XL (DePuy, Warsaw, Ind) metal-on-metal hip arthroplasty offers the advantage of stability and increased motion. However, an alarming number of early failures prompted the evaluation of patients treated with this system. A prospective study of patients who underwent arthroplasty with the ASR XL system was performed. Patients with 2-year follow-up or any revision were included. Failure rates, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and radiographs were evaluated. Ninety-five patients (105 hips) were included. There were 16 revisions. Thirteen (12%) were aseptic acetabular failures. Eight were revised for aseptic loosening; 4, for metallosis; 1, for malposition; 2, for infection; and 1, for periprosthetic fracture. Mean time to revision was 1.6 years (0.18-3.4 years). The ASR XL with a revision rate of 12% is the second reported 1 piece metal-on-metal system with a significant failure rate at early follow-up. This particular class of implants has inherent design flaws that lead to early failure.