THA using metal-on-metal articulation in active patients younger than 50 years
THA using metal-on-metal articulation in active patients younger than 50 years
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DOI：
10.1007/s11999-007-0045-y
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发表时间：
2008-02-01
影响因子：
4.2
通讯作者：
Migaud, Henri
中科院分区：
文献类型：
--
作者：
Delaunay, Christian P.;Bonnomet, Francois;Migaud, Henri
预期寿命较长的患者和年轻且更活跃的患者的主要关注点是全髋关节置换术的寿命。我们回顾性分析了73例患者的83例非骨水泥型全髋关节置换术，植入金属对金属关节。首次手术时，所有患者年龄均小于50岁（平均年龄41岁），使用Devane等人的系统测量时，80%的患者活动水平为4或5级。28 mm Metasul关节面与三种不同的非骨水泥型钛髋臼部件配合使用。在最近的随访中（平均7.3年），平均Merle d 'Aubigne-Postel评分从术前的11.1分提高到17.4分。我们没有观察到部件松动的影像学证据。10个髋臼部件的透亮区仅限于一个区域。以翻修为终点（即至少更换一个假体或关节面组件）的10年生存率为100%（95%置信区间，90%-100%）。Metasul关节面与非骨水泥型髋臼部件在这一高风险年轻患者人群中仍然很有前景。然而，建议采取额外的后续策略，以确定与金属离子扩散相关的任何可能的长期有害影响。
The main concern of patients with longer life expectancies and of patients who are younger and more active is the longevity of their total hip arthroplasty. We retrospectively reviewed 83 cementless total hip arthroplasties in 73 patients implanted with metal-on-metal articulation. All patients were younger than 50 years old (average age, 41 years) at the time of the index procedure, and 80% of the patients had an activity level graded 4 or 5 when measured with the system of Devane et al. A 28-mm Metasul articulation was used with three different cementless titanium acetabular components. At the most recent followup (average, 7.3 years), the average Merle d'Aubigne-Postel score improved from a preoperative 11.1 points to 17.4 points. We observed no radiographic evidence of component loosening. Ten acetabular components had lucency limited to one zone. The 10-year survivorship with the end point of revision (ie, exchange of at least one prosthetic or bearing component) was 100% (95% confidence interval, 90%-100%). Metasul bearings with cementless acetabular components remain promising in this high-risk younger patient population. However, additional followup strategies are recommended to determine any possible long-term deleterious effects associated with the dissemination of metallic ions.