Long-term results of hemi-resurfacing and metal-on-metal hip resurfacing for osteonecrosis of the femoral head.

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Journal of Artificial Organs Pub Date : 2024-09-01 Epub Date: 2023-09-14 DOI:10.1007/s10047-023-01417-9
Masahiro Hasegawa, Shine Tone, Yohei Naito, Hiroki Wakabayashi, Akihiro Sudo
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Abstract

Purpose: Hemi-resurfacing arthroplasty (Hemi) and metal-on-metal hip resurfacing arthroplasty (HR) were proposed as alternatives to conventional total hip arthroplasty (THA) for patients with osteonecrosis of the femoral head (ONFH). Long-term results were evaluated.

Methods: Twenty-three hips with ONFH were treated, using Hemi in 12 and HR in 11. Mean follow-up was 15 years in the Hemi group and 10 years in the HR group. Long-term outcomes were reviewed retrospectively.

Results: In the Hemi group, 8 hips showed acetabular protrusion and were revised to THA. One of the 8 hips showed femoral loosening. In the HR group, pseudotumor was detected in 4 hips (36%), and 1 hip was revised due to symptomatic pseudotumor. No evidence of any femoral or acetabular loosening was seen in the HR group. Ten-year survival rates were 64.2% and 90.9% in the Hemi and HR groups, respectively. Survival rate in the Hemi group dropped to 22.9% at 15 years.

Conclusions: Long-term results of Hemi for patients with ONFH were very poor, and Hemi should not continue to be used. Although HR had a concern of pseudotumor, it could offer attractive indications for 10 years.

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半人工髋关节置换术和金属髋关节置换术治疗股骨头坏死的长期效果。
目的:针对股骨头坏死(ONFH)患者,提出了半人工关节置换术(Hemi)和金属对金属髋关节置换术(HR)作为传统全髋关节置换术(THA)的替代方案。对长期结果进行了评估:共治疗了23例股骨头坏死患者,其中12例采用Hemi,11例采用HR。Hemi组平均随访15年,HR组平均随访10年。对长期结果进行了回顾性分析:结果:在Hemi组中,有8个髋关节出现髋臼突出,需要进行THA修复。8个髋关节中有1个出现股骨松动。在HR组中,4个髋关节(36%)发现假瘤,1个髋关节因有症状的假瘤进行了翻修。HR组未发现任何股骨或髋臼松动的证据。Hemi组和HR组的十年存活率分别为64.2%和90.9%。15年后,Hemi组的存活率降至22.9%:结论:Hemi治疗ONFH患者的长期效果很差,因此不应继续使用Hemi。虽然HR存在假瘤的隐患,但它可以在10年内提供有吸引力的适应症。
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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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