无骨水泥全髋关节置换术治疗类固醇引起的血管性坏死的中期存活率和临床效果。

Northern clinics of Istanbul Pub Date : 2024-06-24 eCollection Date: 2024-01-01 DOI:10.14744/nci.2023.38107
Muhammed Enes Karatas, Bahattin Kemah, Mehmet Salih Soylemez, Necdet Saglam
{"title":"无骨水泥全髋关节置换术治疗类固醇引起的血管性坏死的中期存活率和临床效果。","authors":"Muhammed Enes Karatas, Bahattin Kemah, Mehmet Salih Soylemez, Necdet Saglam","doi":"10.14744/nci.2023.38107","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN).</p><p><strong>Methods: </strong>A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria.</p><p><strong>Results: </strong>The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29-55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60-92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a \"bone ingrowth\" in 16 (89%) hips, \"suspected in-growth\" in 1 (5.6%) hip and \"suboptimum but stable\" femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842).</p><p><strong>Conclusion: </strong>Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 3","pages":"219-224"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237835/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mid-term survivorship and clinical results of cementless total hip arthroplasty for steroid-induced avascular necrosis.\",\"authors\":\"Muhammed Enes Karatas, Bahattin Kemah, Mehmet Salih Soylemez, Necdet Saglam\",\"doi\":\"10.14744/nci.2023.38107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN).</p><p><strong>Methods: </strong>A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria.</p><p><strong>Results: </strong>The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29-55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60-92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a \\\"bone ingrowth\\\" in 16 (89%) hips, \\\"suspected in-growth\\\" in 1 (5.6%) hip and \\\"suboptimum but stable\\\" femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842).</p><p><strong>Conclusion: </strong>Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.</p>\",\"PeriodicalId\":94347,\"journal\":{\"name\":\"Northern clinics of Istanbul\",\"volume\":\"11 3\",\"pages\":\"219-224\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237835/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Northern clinics of Istanbul\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14744/nci.2023.38107\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Northern clinics of Istanbul","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/nci.2023.38107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

研究目的本研究旨在评估目前无骨水泥全髋关节置换术(THA)治疗类固醇引起的血管坏死(AVN)的中期植入存活率、失败模式、放射学结果和临床疗效:方法:扫描2012年1月至2017年11月的5年时间跨度,进行5年随访,共纳入15名患者(18个髋关节),他们接受了超高分子量聚乙烯(UHMWPE)和新设计的其他头和衬垫组件植入手术。只有因类固醇引起的 AVN 而接受手术的患者才被纳入研究范围。酒精诱发、特发性和外伤性 AVN 患者不在研究范围内。研究的主要结果是哈里斯髋关节评分(HHS)以及是否出现松动、骨溶解、聚乙烯磨损或再次手术(无论是否对组件进行翻修)。无骨水泥股骨组件的固定情况根据Engh标准进行评估:研究组由 15 名患者的 18 个髋关节组成。平均年龄为 47.6±8.1 (29-55) 岁。所有患者均使用无骨水泥股骨柄和髋臼杯。一名患者(5.6%)的所有组件均发现化脓性松动。所有患者的平均HHS评分为83.3±7.2(60-92)分。在18个髋关节中,83%(15个髋关节)、5.6%(1个髋关节)、5.6%(1个髋关节)和5.6%(1个髋关节)的HHS评分为好、差、一般和优。所有患者均未发现陶瓷或聚乙烯衬垫磨损。Engh分级表显示,16个(89%)髋关节出现 "骨质增生",1个(5.6%)髋关节出现 "疑似骨质增生",1个(5.6%)患者在翻修手术前出现化脓性松动(5.6%),股骨固定 "不理想但稳定"。股骨柄设计与Engh评分之间无明显相关性(P=0.842):结论:现代全髋关节置换系统,包括陶瓷上陶瓷或陶瓷上聚乙烯顶板选项和无骨水泥股骨柄,为类固醇诱发的AVN治疗提供了良好的中期存活率和积极的临床结果。不过,要获得更精确的数据,还需要进行样本量更大的长期随访研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mid-term survivorship and clinical results of cementless total hip arthroplasty for steroid-induced avascular necrosis.

Objective: The purpose of the present study was to evaluate the mid-term implant survivorship, modes of failure, radiographic results, and clinical outcomes of current cementless total hip arthroplasty (THA) treatment designs for steroid-induced avascular necrosis (AVN).

Methods: A time span of 5 years between January 2012 and November 2017 was scanned to accommodate 5 years of follow-up and a total of 15 patients (18 hips), who had undergone implantation of ultra-high molecular weight polyethylene (UHMWPE) and newly designed other head and liner components, were included in the study. Only patients operated for steroid-induced AVN were included in the study. Patients with alcohol-induced, idiopathic, and traumatic AVN were excluded from the study. The primary outcomes were the assessments of Harris Hip Score (HHS) and the presence of loosening, osteolysis, polyethylene wear or a reoperation (with or without revision of components). The fixation of cementless femoral components was assessed according to Engh criteria.

Results: The study group consisted of 18 hips from 15 patients. The mean age was 47.6±8.1 (29-55) years. A cementless femoral stem and acetabular cup were used for all patients. Septic loosening was detected in all components of one patient (5.6%). The mean HHS score was 83.3±7.2 (60-92) for all patients. Of the 18 hips, 83% (15 hips), 5.6% (1 hip), 5.6% (1 hip), and 5.6% (1 hip) had good, poor, fair, and excellent HHS scores. Ceramic or polyethylene liner wear was not detected in any of the patients. The Engh Grading Scale revealed a "bone ingrowth" in 16 (89%) hips, "suspected in-growth" in 1 (5.6%) hip and "suboptimum but stable" femoral fixation in a patient with septic loosening (5.6%) just before revision surgery. There was no significant correlation between femoral stem design and Engh score (p=0.842).

Conclusion: Modern total hip arthroplasty systems, including ceramic on ceramic or ceramic on polyethylene headliner options with cementless femoral stem, offer promising mid-term survivorship and positive clinical outcomes for steroid-induced AVN treatment. However, studies including long-term follow-ups with larger sample size are needed to obtain more precise data.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信