Aseptic Failure: How Does the CompressA® Implant Compare to Cemented Stems?
Aseptic Failure: How Does the CompressA® Implant Compare to Cemented Stems?
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DOI：
10.1007/s11999-011-2159-5
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发表时间：
2012-03-01
影响因子：
4.2
通讯作者：
O'Donnell, Richard J.
中科院分区：
文献类型：
--
作者：
Pedtke, Andrew C.;Wustrack, Rosanna L.;O'Donnell, Richard J.
由于无菌性松动导致的传统假体假体重建失败仍然是维持肢体完整性和功能的挑战。Compress（A (R)）假体（Biomet Inc ., Warsaw， IN， USA）试图通过独特的技术创新来避免无菌失败。虽然现有文献表明压缩（A (R)）和有根植入物在短期内的存活率相似，但研究受到人群规模和随访时间的限制。因此，我们比较了(1)Compress（A (R)）和骨水泥髓内柄之间的无菌失败率，(2)评估了整体中期种植体存活率。我们回顾了26例使用Compress（A (R)）种植体的患者和26例使用骨水泥髓内根的患者。这些患者的手术时间超过3年。分析的重点是与种植体存活相关的因素，包括年龄、性别、诊断、感染、无菌性松动、局部复发和骨折。最小随访时间为0.32年（平均6.2年，范围0.32-9.2年）。使用Compress（a (R)）种植体的1例（3.8%）患者和使用骨水泥髓内茎的3例（11.5%）患者发生无菌失败。压缩（A (R)）组的5年种植体存活率为83.5%，骨水泥髓内柄组的5年种植体存活率为66.6%。Compress（A (R)）假体仍然是股骨远端肢体保留手术的可靠选择。关于无菌失败的数据是令人鼓舞的，在中期随访中，与骨水泥假体置换术的存活率相当。III级，治疗性研究。有关证据水平的完整描述，请参见作者指南。
Failure of endoprosthetic reconstruction with conventional stems due to aseptic loosening remains a challenge for maintenance of limb integrity and function. The Compress(A (R)) implant (Biomet Inc, Warsaw, IN, USA) attempts to avoid aseptic failure by means of a unique technologic innovation. Though the existing literature suggests survivorship of Compress(A (R)) and stemmed implants is similar in the short term, studies are limited by population size and followup duration.We therefore compared (1) the rate of aseptic failure between Compress(A (R)) and cemented intramedullary stems and (2) evaluated the overall intermediate-term implant survivorship.We reviewed 26 patients with Compress(A (R)) implants and 26 matched patients with cemented intramedullary stems. The patients were operated on over a 3-year period. Analysis focused on factors related to implant survival, including age, sex, diagnosis, infection, aseptic loosening, local recurrence, and fracture. Minimum followup was 0.32 years (average, 6.2 years; range, 0.32-9.2 years).Aseptic failure occurred in one (3.8%) patient with a Compress(A (R)) implant and three (11.5%) patients with cemented intramedullary stems. The 5-year implant survival rate was 83.5% in the Compress(A (R)) group and 66.6% in the cemented intramedullary stem group.The Compress(A (R)) implant continues to be a reliable option for distal femoral limb salvage surgery. Data regarding aseptic failure is encouraging, with equivalent survivorship against cemented endoprosthetic replacement at intermediate-term followup.Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.