28、32、36 mm不同罩杯股骨头初次全髋关节置换术后复位率及脱位的比较

W. Hoskins, Sophia Rainbird, C. Holder, J. Stoney, S. Graves, R. Bingham
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On page 1462, in the first sentence of the Abstract section entitled “Results,” the phrase that had read “and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003), but more dislocations than 32-mm heads (HR for >2 weeks = 2.25 [95% CI, 1.13 to 4.49]; p = 0.021)” now reads “and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003) and 32-mm heads (HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88]; p = 0.021).” On page 1468, in the last sentence of the section entitled “Acetabular Components with a Diameter of <51 mm,” the phrase that had read “and HR for ≥2 weeks = 2.25 [95% CI, 1.13 to 4.49; p = 0.021]) (Fig. 3)” now reads “and HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88; p = 0.021]) (Fig. 3).” Finally, on page 1466, in the upper right corner of Figure 3, under “32mm vs 36mm,” the second line that had read “2Wks+: HR=2.25 (1.13, 4.49), p=0.021” now reads “2Wks+: HR=0.44 (0.22, 0.88), p= 0.021.” Background: The acetabular component diameter can influence the choice of femoral head size in total hip arthroplasty (THA). We compared the rates of revision by femoral head size for different acetabular component sizes. Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for patients undergoing primary THA for a diagnosis of osteoarthritis from September 1999 to December 2019. Acetabular components were stratified into quartiles by size: <51 mm, 51 to 53 mm, 54 to 55 mm, and 56 to 66 mm. Femoral head sizes of 28 mm, 32 mm, and 36 mm were compared for each cup size. The primary outcome was the cumulative percent revision (CPR) for all aseptic causes and for dislocation. The results were adjusted for age, sex, femoral fixation, femoral head material, year of surgery, and surgical approach and were stratified by femoral head material. Results: For acetabular components of <51 mm, 32-mm (hazard ratio [HR] = 0.75 [95% confidence interval (CI), 0.57 to 0.97]; p = 0.031) and 36-mm femoral heads (HR = 0.58 [95% CI, 0.38 to 0.87]; p = 0.008) had a lower CPR for aseptic causes than 28-mm heads; and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003), and 32-mm heads (HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88]; p = 0.021). For 51 to 53-mm, 54 to 55-mm, and 56 to 66-mm-diameter acetabular components, there was no difference in the CPR for aseptic causes among head sizes. A femoral head size of 36 mm had fewer dislocations in the first 2 weeks than a 32-mm head for the 51 to 53-mm acetabular components (HR for <2 weeks = 3.79 [95% CI, 1.23 to 11.67]; p = 0.020) and for the entire period for 56 to 66-mm acetabular components (HR = 1.53 [95% CI, 1.05 to 2.23]; p = 0.028). The reasons for revision differed for each femoral head size. There was no difference in the CPR between metal and ceramic heads. Conclusions: There is no clear advantage to any single head size except with acetabular components of <51 mm, in which 32-mm and 36-mm femoral heads had lower rates of aseptic revision. If stability is prioritized, 36-mm femoral heads may be indicated. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.","PeriodicalId":22579,"journal":{"name":"The Journal of Bone and Joint Surgery","volume":"60 1","pages":"1462 - 1474"},"PeriodicalIF":0.0000,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"7","resultStr":"{\"title\":\"A Comparison of Revision Rates and Dislocation After Primary Total Hip Arthroplasty with 28, 32, and 36-mm Femoral Heads and Different Cup Sizes\",\"authors\":\"W. Hoskins, Sophia Rainbird, C. Holder, J. Stoney, S. Graves, R. Bingham\",\"doi\":\"10.2106/JBJS.21.01101\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Update This article was updated on August 17, 2022, because of previous errors, which were discovered after the preliminary version of the article was posted online. 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We compared the rates of revision by femoral head size for different acetabular component sizes. Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for patients undergoing primary THA for a diagnosis of osteoarthritis from September 1999 to December 2019. Acetabular components were stratified into quartiles by size: <51 mm, 51 to 53 mm, 54 to 55 mm, and 56 to 66 mm. Femoral head sizes of 28 mm, 32 mm, and 36 mm were compared for each cup size. The primary outcome was the cumulative percent revision (CPR) for all aseptic causes and for dislocation. The results were adjusted for age, sex, femoral fixation, femoral head material, year of surgery, and surgical approach and were stratified by femoral head material. Results: For acetabular components of <51 mm, 32-mm (hazard ratio [HR] = 0.75 [95% confidence interval (CI), 0.57 to 0.97]; p = 0.031) and 36-mm femoral heads (HR = 0.58 [95% CI, 0.38 to 0.87]; p = 0.008) had a lower CPR for aseptic causes than 28-mm heads; and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003), and 32-mm heads (HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88]; p = 0.021). For 51 to 53-mm, 54 to 55-mm, and 56 to 66-mm-diameter acetabular components, there was no difference in the CPR for aseptic causes among head sizes. A femoral head size of 36 mm had fewer dislocations in the first 2 weeks than a 32-mm head for the 51 to 53-mm acetabular components (HR for <2 weeks = 3.79 [95% CI, 1.23 to 11.67]; p = 0.020) and for the entire period for 56 to 66-mm acetabular components (HR = 1.53 [95% CI, 1.05 to 2.23]; p = 0.028). The reasons for revision differed for each femoral head size. There was no difference in the CPR between metal and ceramic heads. Conclusions: There is no clear advantage to any single head size except with acetabular components of <51 mm, in which 32-mm and 36-mm femoral heads had lower rates of aseptic revision. If stability is prioritized, 36-mm femoral heads may be indicated. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.\",\"PeriodicalId\":22579,\"journal\":{\"name\":\"The Journal of Bone and Joint Surgery\",\"volume\":\"60 1\",\"pages\":\"1462 - 1474\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-06-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of Bone and Joint Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2106/JBJS.21.01101\",\"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 and Joint Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.21.01101","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 7

摘要

由于之前的错误,本文于2022年8月17日更新,这些错误是在文章的初步版本发布到网上后发现的。在第1462页,标题为“结果”的摘要部分的第一句话中,“和36毫米的头比28毫米的头有更少的脱位(HR = 0.33 [95% CI, 0.16至0.68];p = 0.003),但脱位多于32毫米头(HR >2周= 2.25 [95% CI, 1.13 ~ 4.49];p = 0.021)“now reads”和36-mm头的脱位少于28-mm (HR = 0.33 [95% CI, 0.16至0.68];p = 0.003)和32毫米头(HR≥2周= 0.44 [95% CI, 0.22 ~ 0.88];P = 0.021)。在第1468页,题为“直径<51 mm的髋臼组件”部分的最后一句话中,有这样的短语:and HR for≥2周= 2.25 [95% CI, 1.13 ~ 4.49;p = 0.021])(图3)“now reads”和HR≥2周= 0.44 [95% CI, 0.22 ~ 0.88;最后,在第1466页,在图3的右上角,“32mm vs 36mm”下面,第二行原来是“2Wks+: HR=2.25 (1.13, 4.49), p=0.021”,现在变成了“2Wks+: HR=0.44 (0.22, 0.88), p=0.021”。背景:髋臼假体直径可影响全髋关节置换术中股骨头大小的选择。我们比较了不同髋臼假体大小的股骨头大小的翻修率。方法:分析1999年9月至2019年12月期间澳大利亚骨科协会国家关节置换登记处的数据,这些数据来自于诊断为骨关节炎的原发性THA患者。髋臼组件按尺寸分为四分位数:<51 mm、51 ~ 53 mm、54 ~ 55 mm和56 ~ 66 mm。不同罩杯的股骨头尺寸分别为28mm、32mm和36mm。主要结果是所有无菌原因和脱位的累积百分比修正(CPR)。结果根据年龄、性别、股骨固定、股骨头材料、手术年份和手术入路进行调整,并按股骨头材料分层。结果:对于髋臼假体<51 mm、32 mm(风险比[HR] = 0.75[95%可信区间(CI), 0.57 ~ 0.97];p = 0.031)和36-mm股骨头(HR = 0.58 [95% CI, 0.38 ~ 0.87];p = 0.008)无菌原因的CPR低于28毫米头部;36-mm头的脱位比28-mm头少(HR = 0.33 [95% CI, 0.16 ~ 0.68];p = 0.003), 32毫米头(HR≥2周= 0.44 [95% CI, 0.22 ~ 0.88];P = 0.021)。对于51 ~ 53 mm、54 ~ 55 mm和56 ~ 66 mm直径的髋臼组件,不同头部尺寸的无菌原因的CPR无差异。对于51 ~ 53 mm的髋臼假体,36 mm股骨头比32 mm股骨头在前2周发生的脱位更少(HR <2周= 3.79 [95% CI, 1.23 ~ 11.67];p = 0.020), 56 ~ 66 mm髋臼假体的整个周期(HR = 1.53 [95% CI, 1.05 ~ 2.23];P = 0.028)。股骨头大小不同,翻修的原因也不同。金属头和陶瓷头的心肺复苏术没有差别。结论:除了髋臼假体<51 mm外,任何单一股骨头尺寸都没有明显的优势,其中32 mm和36 mm股骨头的无菌翻修率较低。如果优先考虑稳定性,可能需要36mm股骨头。证据等级:治疗性III级。有关证据水平的完整描述,请参见作者说明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Comparison of Revision Rates and Dislocation After Primary Total Hip Arthroplasty with 28, 32, and 36-mm Femoral Heads and Different Cup Sizes
Update This article was updated on August 17, 2022, because of previous errors, which were discovered after the preliminary version of the article was posted online. On page 1462, in the first sentence of the Abstract section entitled “Results,” the phrase that had read “and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003), but more dislocations than 32-mm heads (HR for >2 weeks = 2.25 [95% CI, 1.13 to 4.49]; p = 0.021)” now reads “and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003) and 32-mm heads (HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88]; p = 0.021).” On page 1468, in the last sentence of the section entitled “Acetabular Components with a Diameter of <51 mm,” the phrase that had read “and HR for ≥2 weeks = 2.25 [95% CI, 1.13 to 4.49; p = 0.021]) (Fig. 3)” now reads “and HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88; p = 0.021]) (Fig. 3).” Finally, on page 1466, in the upper right corner of Figure 3, under “32mm vs 36mm,” the second line that had read “2Wks+: HR=2.25 (1.13, 4.49), p=0.021” now reads “2Wks+: HR=0.44 (0.22, 0.88), p= 0.021.” Background: The acetabular component diameter can influence the choice of femoral head size in total hip arthroplasty (THA). We compared the rates of revision by femoral head size for different acetabular component sizes. Methods: Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for patients undergoing primary THA for a diagnosis of osteoarthritis from September 1999 to December 2019. Acetabular components were stratified into quartiles by size: <51 mm, 51 to 53 mm, 54 to 55 mm, and 56 to 66 mm. Femoral head sizes of 28 mm, 32 mm, and 36 mm were compared for each cup size. The primary outcome was the cumulative percent revision (CPR) for all aseptic causes and for dislocation. The results were adjusted for age, sex, femoral fixation, femoral head material, year of surgery, and surgical approach and were stratified by femoral head material. Results: For acetabular components of <51 mm, 32-mm (hazard ratio [HR] = 0.75 [95% confidence interval (CI), 0.57 to 0.97]; p = 0.031) and 36-mm femoral heads (HR = 0.58 [95% CI, 0.38 to 0.87]; p = 0.008) had a lower CPR for aseptic causes than 28-mm heads; and 36-mm heads had fewer dislocations than 28-mm (HR = 0.33 [95% CI, 0.16 to 0.68]; p = 0.003), and 32-mm heads (HR for ≥2 weeks = 0.44 [95% CI, 0.22 to 0.88]; p = 0.021). For 51 to 53-mm, 54 to 55-mm, and 56 to 66-mm-diameter acetabular components, there was no difference in the CPR for aseptic causes among head sizes. A femoral head size of 36 mm had fewer dislocations in the first 2 weeks than a 32-mm head for the 51 to 53-mm acetabular components (HR for <2 weeks = 3.79 [95% CI, 1.23 to 11.67]; p = 0.020) and for the entire period for 56 to 66-mm acetabular components (HR = 1.53 [95% CI, 1.05 to 2.23]; p = 0.028). The reasons for revision differed for each femoral head size. There was no difference in the CPR between metal and ceramic heads. Conclusions: There is no clear advantage to any single head size except with acetabular components of <51 mm, in which 32-mm and 36-mm femoral heads had lower rates of aseptic revision. If stability is prioritized, 36-mm femoral heads may be indicated. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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