Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012 Sep; 156(3)
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2012 Sep; 156(3)
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Biomed Pap Med Fac Univ Palacky Olomouc 捷克共和国。
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Martin Janouta
中科院分区：
文献类型：
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作者：
Jiri Galloa;Stuart Barry Goodmanb;Jiri Lostaka;Martin Janouta
背景。陶瓷对陶瓷（COC）全髋关节置换术（THA）的开发是为了减少磨损碎片，从而减少骨溶解和无菌性松动的发生，尤其是在年轻患者中。基于当前 COC 轴承优异的摩擦学行为和陶瓷颗粒相对较低的生物活性，预计这些植入物的存活率将显着提高。方法。我们使用手动搜索来识别 PubMed 中报告 COC THAs 临床数据的所有相关研究。目的是确定当前的 COC THA 是否比非 COC THA 提供更好的临床结果和生存率。结果。对早期陶瓷轴承的研究显示，20 年随访后平均存活率为 68% 至 84%，与非 COC THA 的存活率相当。对当前陶瓷轴承的研究表明，10 年免修正间隔为 92% 至 99%。这些结果与最好的非 COC THA 的生存率相当。然而，仍然存在关于夹层陶瓷内衬断裂、吱吱声以及股骨颈撞击陶瓷内衬边缘导致碎裂的担忧，特别是对于年轻和体力活跃的患者。结论。与最好的非 COC THA 相比，目前的 COC THA 在 10 年随访中可实现同等但未改善的生存率。根据这篇综述，我们建议外科医生在考虑适合接受 THA 的年轻、非常活跃的患者时，权衡当前 COC THA 与其他支撑表面相比的潜在优点和缺点。
Background. Ceramic on ceramic (COC) total hip arthroplasty (THA) was developed to reduce wear debris and accordingly, the occurrence of osteolysis and aseptic loosening especially in younger patients. Based on the excellent tribological behavior of current COC bearings and the relatively low biological activity of ceramic particles, significant improvement in survivorship of these implants is expected. Methods. We used manual search to identify all relevant studies reporting clinical data on COC THAs in PubMed. The objective was to determine whether current COC THA offers a better clinical outcome and survivorship than non-COC THA. Results. Studies with early generation ceramic bearings yielded 68% to 84% mean survivorship at 20 years follow-up which is comparable with the survivorship of non-COC THAs. Studies on current ceramic bearings report a 10-year revision-free interval of 92% to 99%. These outcomes are comparable to the survivorship of the best non-COC THAs. However, there are still concerns regarding fracture of sandwich ceramic liners, squeaking, and impingement of the femoral neck on the rim of the ceramic liner leading to chipping, especially in younger and physically active patients. Conclusion. Current COC THA leads to equivalent but not improved survivorship at 10 years follow-up in comparison to the best non-COC THA. Based on this review, we recommend that surgeons weigh the potential advantages and disadvantages of current COC THA in comparison to other bearing surfaces when considering young very active patients who are candidates for THA.
DOI：
10.1302/0301-620x.90b8.20737
发表时间：
2008-08-01
影响因子：
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作者：
Richards, L.;Brown, C.;Tipper, J. L.
通讯作者：
Tipper, J. L.