Long-term clinical results and patient satisfaction of a metaphyseal-engaging anatomic cementless femoral component in total hip arthroplasty.

IF 2 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-12-01 Epub Date: 2024-09-21 DOI:10.1007/s00264-024-06322-1

Young-Hoo Kim, Jang-Won Park, Young-Soo Jang, Eun-Jung Kim

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Abstract

Purpose: There is relatively little information on the long-term clinical results of patients aged < 50 years with a contemporary total hip arthroplasty (THA), although a high rate of revision is projected for this group. Therefore, the purpose of this study was to evaluate the long-term results (a minimum of 21 years) of a metaphyseal-engaging anatomic cementless total hip prosthesis in patients aged < 50 years at the time of their THA.

Methods: This study included 360 patients (498 hips), specifically 212 men and 148 women. The mean age of the patients at the time of their THA was 45.8 ± 8.1 years. The predominant diagnosis was osteonecrosis (56%). Demographic data, the Harris hip score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the University of California, Los Angeles (UCLA) activity score were recorded. Radiographic evaluation and dual-energy X-ray absorptiometry (DEXA) scanning were used to evaluate implant fixation, bone remodelling, and osteolysis. The mean follow-up was 25.2 year (range 21-28 years).

Results: At the latest follow-up, the mean Harris hip, WOMAC, and UCLA activity scores were 93, 10, and 6.7 points, respectively. No patients had thigh pain. All hips had osseous integration of the acetabular and femoral components. No patient had grade 3 stress shielding. The 28-year survival rate was 98.2% (95% confidence interval [CI] 95-100%) for the acetabular components and 98.8% (95% CI 95-100%) for the femoral components. Overall, 90% of the patients were satisfied with the THA results.

Conclusion: The results suggest that a metaphyseal-engaging anatomic cementless femoral stem with alumina-on-alumina ceramic articulation provide outstanding long-term fixation and substantial pain relief well into the 3rd decade after surgery. Furthermore, there was no alumina ceramic fracture or osteolysis. Moreover, approximately 90% of the patients were satisfied with the results of their THA.

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全髋关节置换术中骨骺连接解剖型无骨水泥股骨组件的长期临床效果和患者满意度。

目的：有关高龄患者长期临床效果的信息相对较少：这项研究包括 360 例患者（498 个髋关节），其中男性 212 例，女性 148 例。患者接受全髋关节置换术时的平均年龄为（45.8 ± 8.1）岁。主要诊断为骨坏死（56%）。记录了人口统计学数据、哈里斯髋关节评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）以及加州大学洛杉矶分校（UCLA）活动评分。采用放射学评估和双能 X 射线吸收测量（DEXA）扫描评估植入物的固定情况、骨质重塑和骨溶解情况。平均随访时间为 25.2 年（21-28 年不等）：最近一次随访时，Harris髋关节、WOMAC和UCLA活动评分的平均值分别为93分、10分和6.7分。没有患者出现大腿疼痛。所有髋关节的髋臼和股骨组件均已骨性融合。没有患者出现三级应力屏蔽。髋臼组件的28年存活率为98.2%（95%置信区间[CI] 95-100%），股骨组件的28年存活率为98.8%（95%置信区间[CI] 95-100%）。总体而言，90%的患者对THA结果表示满意：结果表明，带有氧化铝-氧化铝陶瓷关节的骺端啮合解剖型无骨水泥股骨柄可提供出色的长期固定效果，并在术后第3个10年仍能有效缓解疼痛。此外，没有发生氧化铝陶瓷断裂或骨质溶解。此外，约 90% 的患者对 THA 的效果表示满意。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.