Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head.
Cementless total hip arthroplasty in patients with osteonecrosis of the femoral head.
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DOI：
10.1097/00003086-199511000-00013
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发表时间：
1995-11
影响因子：
4.2
通讯作者：
Young-Hoo Kim;Jeong-Hwan Oh;Seung-Hwan Oh
中科院分区：
文献类型：
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作者：
Young-Hoo Kim;Jeong-Hwan Oh;Seung-Hwan Oh
作者对61例(78个髋关节)股骨头缺血性坏死患者进行了研究，这些患者在初次行无骨水泥多孔涂层全髋关节置换术后获得了平均7.2年(范围6-9年)的随访。这项研究是为了确定非骨水泥多孔涂层假体是否比报道的使用现代技术的骨水泥全髋关节置换术有任何优点。患者手术时平均年龄48岁(20-73岁)。平均髋关节评分45.6分(28~75分)，术后随访7.2年，平均90.3分(34~100分)。78例人工关节置换术中有16例失败，总失败率为20.5%。失效髋关节中，股骨假体松动11例，股骨及髋臼假体松动4例，聚乙烯衬里过度磨损1例。股骨假体4例，髋臼假体5例。在78个髋关节中，21个(27%)的聚乙烯衬里平均磨损5.6 mm(3-9 mm)。髋臼及股骨假体周围骨溶解16例(20.5%)，单纯股骨假体周围骨溶解22例(28.2%)。本系列非骨水泥型全髋关节置换术的股骨假体无菌性松动、聚乙烯衬垫磨损和假体周围骨溶解的发生率高于使用现代技术的骨水泥型全髋关节置换术。
The authors studied 61 patients (78 hips) who had avascular necrosis of the femoral head, seen in followup for an average of 7.2 years (range, 6-9 years) after they had primary cementless porous-coated total hip arthroplasty. This study was undertaken to determine whether cementless porous-coated prostheses have any merit over reported cemented total hip arthroplasty using contemporary techniques. The average age of the patients at the time of surgery was 48 years old (range, 20-73 years). The average preoperative hip score was 45.6 points (range, 28-75 points), which improved to 90.3 points (range, 34-100 points) at the 7.2-year followup examination. Sixteen of 78 arthroplasties failed in the period of followup, for an overall failure rate of 20.5%. Of the failed hips, 11 had femoral component loosening, 4 had femoral and acetabular component loosening, and 1 had excessive wear in the polyethylene liner. Four femoral components and 5 acetabular components were revised. Twenty-one of the 78 hips (27%) had an average of 5.6 mm (range, 3-9 mm) of wear in the polyethylene liner. Sixteen (20.5%) of 78 hips had acetabular and femoral periprosthetic osteolysis, and 22 (28.2%) hips had femoral periprosthetic osteolysis only. The cementless total hip arthroplasty in this series had a higher incidence of aseptic loosening of the femoral component, polyethylene liner wear, and periprosthetic osteolysis than that reported for cemented total hip arthroplasty using contemporary techniques.