髋关节置换失败。全髋关节置换术是一个令人满意的解决方案吗?

Abdel-hamid A. Atallah, Yaser El-Sayed Hassan Wahd, Mohamed A Abdel-AAl
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摘要

背景:髋关节表面置换术(HRA)自20世纪50年代以来一直被应用。由于其提出的优点,该概念适用于患有退行性髋关节疾病的年轻活跃患者。大多数国家登记处的修订率接近3.5%。转换为全髋关节置换术可能是老年患者和那些活动水平改变和不再需要髋关节表面置换的患者的正确选择。目的:本研究的目的是评估失败的髋关节置换术转为全髋关节置换术的中期结果。研究设计:前瞻性案例系列研究。股骨变薄4例(6例),构件脱位3例,腹股沟持续性疼痛及咔咔声3例,构件磨损5例。在25例患者中,两个组件都进行了翻修,而其余10例仅进行了股骨组件翻修。结果:平均术前髋关节评分(Oxford、WOMAC、Harris和UCLA髋关节评分)分别为19.4、78.3、33、8和4.1,末次随访时分别提高至39.8、11.1、92.3和8.1,较术前评分有统计学意义(p < 0.0001)。无神经系统、血管、深部感染或植入物失效。并发症3例(8.6%),手术部位感染并发浆液引流7天以上1例,异位骨化1例,腹股沟残余疼痛1例。所有患者都对疼痛的缓解感到满意。术后平均牛津评分为17.4分,哈里斯评分为89.8分,WOMAC评分为6.1分。与术前评分相比,有统计学意义上的显著改善(每个评分p < 0.0001)。结论:失败的髋关节表面置换术转化为THA具有较高的满意率。这些结果与翻修全髋关节置换术的结果比较有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hip Resurfacing Arthroplasty Failure. Conversion to Total Hip is it a Favorable Solution with Satisfactory Outcomes?
Background: Hip resurfacing arthroplasty (HRA) had been utilized since the 1950s. The concept favoured for selected young active patients with degenerative hip disease owing to its proposed advantages. Revision rate in most national registries nearly 3.5%. Conversion to total hip replacement may be the correct option for old patients and those whose activity levels changed and the need for hip resurfacing no longer required. Purpose: The aim of this study is to assess the midterm outcomes of converting failed hip resurfacing arthroplasty to total hip arthroplasty. Study design: Prospective case series study. femoral thinning (4 (6 cases) component dislocation (3cases) persistent groin pain and clicking (3 cases) and wear of components (5 cases). Both components revised in Twenty-five patients while the remaining ten underwent revision of femoral component only. Results: Mean Preoperative hip scores (Oxford, WOMAC, Harris and UCLA hip scores) were 19.4, 78.3, 33,8 and 4.1 respectively improved at last follow-up to 39.8, 11.1, 92.3 and 8.1 respectively representing statistically significant improvements over pre-operative scores (p < 0.0001 for each score) No cases of neurological, vascular, deep infection or implant failure. There were 3 cases (8.6%) with complications included surgical site infection with serous drainage for more than seven days (one case), heterotopic ossification (one case) and residual groin pain in one case. All patients were satisfied particularly by their pain relief. Average postoperative Oxford, Harris and WOMAC hip scores were 17.4, 89.8 and 6.1 respectively. Representing statistically significant improvements over preoperative scores (p < 0.0001 for each score). Conclusions: Conversion of failed hip resurfacing to THA has high satisfaction rates. These results compare favorably with those for revision total hip arthroplasty.
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