The premature failure of the Charnley Elite-Plus stem - A confirmation of RSA predictions
The premature failure of the Charnley Elite-Plus stem - A confirmation of RSA predictions
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DOI：
10.1302/0301-620x.88b2.17055
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发表时间：
2006-02-01
影响因子：
--
通讯作者：
Murray, DW
中科院分区：
文献类型：
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作者：
Hauptfleisch, J;Glyn-Jones, S;Murray, DW
我们进行了一项临床和影像学研究，以确定Charnley Elite-Plus股骨部件的失效率。我们的目的是证实或反驳先前X线立体摄影测量分析研究的预测，在该研究中，20%的Charnley Elite-Plus股骨柄显示股骨头快速后移。据预测，该设备的早期失败率很高。我们在髋关节置换术后平均9年对118名患者进行了检查，其中包括来自最初伦琴立体摄影测量研究的19名患者。记录翻修手术的次数，并进行临床和影像学检查，当单纯翻修被认为是失败时，10年时股骨柄的存活率为83%。当放射学上松动的股骨柄也被认为是失败时，这一比例下降到59%。所有先前在X线立体摄影研究中显示头部高度后移的患者都失败了，这是非常显著的差异。（p = 0.002）在术后2年测量的失效和非失效股骨柄之间的股骨头后移中，但这两组之间的下沉没有显著差异。我们的研究表明，Charnley Elite-此外，股骨部件的失效率高得不可接受。它证实，早期评估新的组件是重要的，伦琴立体摄影测量是一个很好的工具。我们的研究结果还表明，股骨头快速后移是过早松动的预测因素，并且是比下沉更好的预测因素。
We performed a clinical and radiological study to determine the rate of failure of the Charnley Elite-Plus femoral component. Our aim was to confirm or refute the predictions of a previous roentgen stereophotogrammetric analysis study in which 20% of the Charnley Elite-Plus stems had shown rapid posterior head migration. It was predicted that this device would have a high early rate of failure.We examined 118 patients at a mean of nine years after hip replacement, including the 19 patients from the original roentgen stereophotogrammetric study. The number of revision procedures was recorded and clinical and radiological examinations were performed.The rate of survival of the femoral stems at ten years was 83% when revision alone was considered to be a failure. It decreased to 59% when a radiologically loose stem was also considered to be a failure. All the patients previously shown in the roentgen stereophotogrammetric study to have high posterior head migration went on to failure.There was a highly significant difference (p = 0.002) in posterior head migration measured at two years after operation between failed and non-failed femoral stems, but there was no significant difference in subsidence between these two groups.Our study has shown that the Charnley Elite-Plus femoral component has an unacceptably high rate of failure. It confirms that early evaluation of new components is important and that roentgen stereophotogrammetric is a good tool for this. Our findings have also shown that rapid posterior head migration is predictive of premature loosening and a better predictor than subsidence.