PROGNOSIS OF TOTAL HIP-REPLACEMENT IN SWEDEN - FOLLOW-UP OF 92,675 OPERATIONS PERFORMED 1978-1990
PROGNOSIS OF TOTAL HIP-REPLACEMENT IN SWEDEN - FOLLOW-UP OF 92,675 OPERATIONS PERFORMED 1978-1990
复制标题
DOI：
10.3109/17453679308993679
复制
发表时间：
1993-10-01
期刊：
影响因子：
--
通讯作者：
AHNFELT, L
中科院分区：
文献类型：
--
作者：
MALCHAU, H;HERBERTS, P;AHNFELT, L
瑞典骨科协会于1979年开始对全髋关节置换术（THR）后的所有再次手术进行前瞻性国家多中心研究。该材料包括在瑞典进行的所有THR，目前每年超过10，000例或每100，000名居民130例THR;非骨水泥植入物的使用率不到2%。翻修的主要原因是无菌性松动（79%）、感染（10%）、技术错误（6%）和脱位（2%）。对于1979年和1983年植入的种植体，深部感染的累积翻修率分别从0.9%下降到<0.5%。以Charnley假体为金标准，分析其他假体的性能。骨水泥固定技术和抗感染措施的改进不断降低了翻修风险。登记册表明，普通骨科医生无法达到专家的结果。然而，全世界绝大多数THR都不是由专家进行的。骨科这一领域的质量保证要求对这些手术的结果进行持续分析。
A prospective, national multi-center study of all reoperations after total hip replacement (THR) was started by the Swedish Orthopedic Association in 1979. The material comprises all THR performed in Sweden, presently more than 10,000 yearly or 130 THR per 100,000 inhabitants; uncemented implants have been used in less than 2 percent. The main reasons for revision have been aseptic loosening 79 percent, infection 10 percent, technical error 6 percent, and dislocation 2 percent. The cumulative rate of revision for deep infection has dropped from 0.9 percent to < 0.5 percent for implants inserted 1979 and 1983, respectively. With the Charnley prosthesis as the gold, standard the performance of other prostheses was analyzed. Improved cementation techniques and anti-infection measures have continuously reduced the revision risk.The register demonstrates that the average ortopedic surgeon cannot match the results achieved by experts. However, the vast majority of THR, worldwide, are not performed by experts. Quality-assurance in this sector of orthopedics demands a continuous analysis of the outcome of these operations.