使用第二代骨水泥技术固定带圈磨砂股骨假体的长期结果:一项中位随访研究

J. Sánchez-Sotelo, D. Berry, S. Harmsen
{"title":"使用第二代骨水泥技术固定带圈磨砂股骨假体的长期结果:一项中位随访研究","authors":"J. Sánchez-Sotelo, D. Berry, S. Harmsen","doi":"10.2106/00004623-200209000-00018","DOIUrl":null,"url":null,"abstract":"Background: So-called second-generation cementing techniques in total hip arthroplasty have been shown to provide better survival of the femoral component than first-generation methods do; however, surface finish and other features of the component design also influence the durability of the reconstruction. The purpose of this study was to determine the results of primary total hip replacement with use of a collared femoral component with a matte-finished surface fixed with second-generation cementing techniques and followed for ten to twenty years.Methods: The study group consisted of 256 consecutive hips in 236 patients who had had a primary total hip arthroplasty with fixation of a Harris Design-2 femoral component with second-generation cementing techniques (use of an intramedullary plug and a cement gun). The mean age of the patients at the time of the operation was sixty-six years. One hundred and twelve patients were male, and 124 were female. Seven patients were lost to follow-up less than ten years after the operation. The median duration of follow-up of the living patients who had not had a revision was 15.4 years.Results: At the time of the most recent follow-up, nineteen femoral components (7%) had been revised because of aseptic loosening, five (2%) had been removed because of deep infection, and one (0.4%) had been revised because of recurrent dislocation. The mean Harris hip score for the surviving patients who had not had a revision improved from 51 points preoperatively to 91 points at the most recent evaluation. At fifteen years, the estimated survival rate of the femoral components was 92.2% with revision due to aseptic loosening as the end point and 90.1% with mechanical failure (radiographic loosening or revision due to aseptic loosening) as the end point. Patients who were younger than fifty years old at the time of the operation had a lower fifteen-year rate of survival of the femoral implant, in terms of both revision due to aseptic loosening (72.3% compared with 95.7%, p = 0.0001) and mechanical failure (72.3% compared with 93.1%, p = 0.005), than did patients who were fifty years or older.Conclusions: Fixation of this collared matte-finished femoral component with use of second-generation cementing techniques for primary total hip replacement provided satisfactory results at ten to twenty years in older patients but less satisfactory results in younger patients.","PeriodicalId":22625,"journal":{"name":"The Journal of Bone & Joint Surgery","volume":"17 1","pages":"1636–1641"},"PeriodicalIF":0.0000,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"36","resultStr":"{\"title\":\"Long-Term Results of Use of a Collared Matte-Finished Femoral Component Fixed with Second-Generation Cementing Techniques: A Fifteen-Year-Median Follow-up Study\",\"authors\":\"J. Sánchez-Sotelo, D. Berry, S. Harmsen\",\"doi\":\"10.2106/00004623-200209000-00018\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: So-called second-generation cementing techniques in total hip arthroplasty have been shown to provide better survival of the femoral component than first-generation methods do; however, surface finish and other features of the component design also influence the durability of the reconstruction. The purpose of this study was to determine the results of primary total hip replacement with use of a collared femoral component with a matte-finished surface fixed with second-generation cementing techniques and followed for ten to twenty years.Methods: The study group consisted of 256 consecutive hips in 236 patients who had had a primary total hip arthroplasty with fixation of a Harris Design-2 femoral component with second-generation cementing techniques (use of an intramedullary plug and a cement gun). The mean age of the patients at the time of the operation was sixty-six years. One hundred and twelve patients were male, and 124 were female. Seven patients were lost to follow-up less than ten years after the operation. The median duration of follow-up of the living patients who had not had a revision was 15.4 years.Results: At the time of the most recent follow-up, nineteen femoral components (7%) had been revised because of aseptic loosening, five (2%) had been removed because of deep infection, and one (0.4%) had been revised because of recurrent dislocation. The mean Harris hip score for the surviving patients who had not had a revision improved from 51 points preoperatively to 91 points at the most recent evaluation. At fifteen years, the estimated survival rate of the femoral components was 92.2% with revision due to aseptic loosening as the end point and 90.1% with mechanical failure (radiographic loosening or revision due to aseptic loosening) as the end point. Patients who were younger than fifty years old at the time of the operation had a lower fifteen-year rate of survival of the femoral implant, in terms of both revision due to aseptic loosening (72.3% compared with 95.7%, p = 0.0001) and mechanical failure (72.3% compared with 93.1%, p = 0.005), than did patients who were fifty years or older.Conclusions: Fixation of this collared matte-finished femoral component with use of second-generation cementing techniques for primary total hip replacement provided satisfactory results at ten to twenty years in older patients but less satisfactory results in younger patients.\",\"PeriodicalId\":22625,\"journal\":{\"name\":\"The Journal of Bone & Joint Surgery\",\"volume\":\"17 1\",\"pages\":\"1636–1641\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2002-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"36\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of Bone & Joint Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2106/00004623-200209000-00018\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of Bone & Joint Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/00004623-200209000-00018","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 36

摘要

背景:在全髋关节置换术中所谓的第二代骨水泥技术已被证明比第一代方法提供更好的股骨假体存活;然而,表面光洁度和组件设计的其他特征也会影响重建的耐久性。本研究的目的是确定首次全髋关节置换术的结果,采用第二代骨水泥技术固定带带股骨假体表面,并随访10至20年。方法:研究组包括236例患者的256个连续髋关节,这些患者接受了Harris Design-2型股骨假体固定和第二代骨水泥技术(使用髓内栓和骨水泥枪)的初次全髋关节置换术。手术时患者的平均年龄为66岁。男性112例,女性124例。7例患者术后10年内失访。未进行翻修的在世患者的中位随访时间为15.4年。结果:在最近的随访中,19例(7%)股骨假体因无菌性松动而复位,5例(2%)因深度感染而复位,1例(0.4%)因复发性脱位而复位。未进行翻修的存活患者的平均Harris髋关节评分从术前的51分提高到最近一次评估的91分。15年时,以无菌性松动翻修为终点的股骨假体的估计存活率为92.2%,以机械故障(放射学松动或无菌性松动翻修)为终点的估计存活率为90.1%。手术时年龄小于50岁的患者,由于无菌性松动(72.3%比95.7%,p = 0.0001)和机械故障(72.3%比93.1%,p = 0.005)导致的股骨内固定15年生存率低于50岁或以上的患者。结论:采用第二代骨水泥技术固定这种带圈的磨砂成品股骨假体用于初次全髋关节置换术,在10至20岁的老年患者中获得了满意的结果,但在年轻患者中则不太满意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Results of Use of a Collared Matte-Finished Femoral Component Fixed with Second-Generation Cementing Techniques: A Fifteen-Year-Median Follow-up Study
Background: So-called second-generation cementing techniques in total hip arthroplasty have been shown to provide better survival of the femoral component than first-generation methods do; however, surface finish and other features of the component design also influence the durability of the reconstruction. The purpose of this study was to determine the results of primary total hip replacement with use of a collared femoral component with a matte-finished surface fixed with second-generation cementing techniques and followed for ten to twenty years.Methods: The study group consisted of 256 consecutive hips in 236 patients who had had a primary total hip arthroplasty with fixation of a Harris Design-2 femoral component with second-generation cementing techniques (use of an intramedullary plug and a cement gun). The mean age of the patients at the time of the operation was sixty-six years. One hundred and twelve patients were male, and 124 were female. Seven patients were lost to follow-up less than ten years after the operation. The median duration of follow-up of the living patients who had not had a revision was 15.4 years.Results: At the time of the most recent follow-up, nineteen femoral components (7%) had been revised because of aseptic loosening, five (2%) had been removed because of deep infection, and one (0.4%) had been revised because of recurrent dislocation. The mean Harris hip score for the surviving patients who had not had a revision improved from 51 points preoperatively to 91 points at the most recent evaluation. At fifteen years, the estimated survival rate of the femoral components was 92.2% with revision due to aseptic loosening as the end point and 90.1% with mechanical failure (radiographic loosening or revision due to aseptic loosening) as the end point. Patients who were younger than fifty years old at the time of the operation had a lower fifteen-year rate of survival of the femoral implant, in terms of both revision due to aseptic loosening (72.3% compared with 95.7%, p = 0.0001) and mechanical failure (72.3% compared with 93.1%, p = 0.005), than did patients who were fifty years or older.Conclusions: Fixation of this collared matte-finished femoral component with use of second-generation cementing techniques for primary total hip replacement provided satisfactory results at ten to twenty years in older patients but less satisfactory results in younger patients.
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