羟基磷灰石陶瓷涂层股骨柄在初级全髋关节置换术中的效果:一份来自英国单一中心的极佳存活率报告。

IF 1.8 Q2 ORTHOPEDICS SICOT-J Pub Date : 2024-01-01 Epub Date: 2024-08-14 DOI:10.1051/sicotj/2024026
Karim M Abdelghafour, Sherif A Khaled, Khaled F M Abdel-Kader, Hazem A Azeem, Nirav N Shah
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引用次数: 0

摘要

背景:羟基磷灰石(HA)涂层股骨柄的引入是为了增强植入物与骨界面的生物固定,从而延长假体的寿命和存活率。我们的目的是评估HA陶瓷(HAC)涂层股骨柄在初级全髋关节置换术(THA)中的长期疗效、评估股骨柄的存活率,并使用患者报告的疗效指标(PROMs)和股骨柄骨结合的放射学评估对患者进行临床评估:这是对2008年6月至2018年12月期间接受初级THA的385名患者(442个髋关节)的回顾性队列进行的前瞻性评估。平均年龄为63.83岁(30-82岁)。随访期间,23 名患者死亡,36 名患者(38 个髋关节)失去随访机会。收集到的326名患者(381个髋关节)的前瞻性数据采用Kaplan-Meier法,以无菌性松动或任何翻修为终点,评估骨干存活率。临床评估采用EuroQol五维(EQ-5D)评分系统,PROM采用牛津髋关节评分(OHS)和Merle D'Aubigne Postel评分(MDP)。放射学评估采用恩格(Engh)髋关节骨整合放射学标准:平均随访时间为9.39年(4-14.5年)。以无菌性松动为终点,HAC涂层股骨柄14年的存活率为100%(95%置信区间[CI],96.7-100%);以任何原因的柄翻修为终点,HAC涂层股骨柄14年的存活率为98.9%(CI,96.7-100%)。平均OHS为44.5(范围为30-48),平均MDP评分为15.87(范围为10-18)。放射学评估显示,所有股骨柄均完全骨结合:结论:这种HAC涂层股骨柄显示了极佳的存活率、功能性结果以及最终随访时的完全骨结合。
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Outcomes of a hydroxyapatite ceramic-coated femoral stem in primary total hip arthroplasty: a report of excellent survivorship from a single United Kingdom centre.

Background: Hydroxyapatite (HA) coated femoral stems were introduced to enhance the biological fixation at the implant-bone interface, aiming to increase the longevity and survival of the prostheses. We aimed to assess the long-term outcomes of an HA ceramic (HAC) coated stem in primary total hip arthroplasty (THA), assess the stem survival, and clinically evaluate the patients using patient-reported outcome measures (PROMs) and radiological evaluation of stem osseointegration.

Patients and methods: This was a prospective evaluation of a retrospective cohort of 385 patients (442 hips) who underwent primary THA between June 2008 and December 2018. The mean age was 63.83 years (range, 30-82 years). During the follow-up duration, 23 patients died, and 36 patients (38 hips) were lost to follow-up. Prospective data collected for 326 patients (381 hips) was used to evaluate stem survival with the Kaplan-Meier method using aseptic loosening or any revision as the endpoint. Clinical evaluation was done using the EuroQol five-dimension (EQ-5D) scoring system and PROMs using the Oxford Hip Score (OHS) and Merle D'Aubigne Postel (MDP) score. Radiological assessments were performed using the Engh radiological criteria for stem osteointegration.

Results: The mean follow-up duration was 9.39 years (range, 4-14.5 years). The survival of the HAC-coated femoral stem was 100% (95% confidence interval [CI], 96.7-100%) at 14 years with aseptic loosening as the endpoint, and 98.9% (CI, 96.7-100%) at 14 years with stem revision for any reason as the endpoint. The mean OHS was 44.5 (range, 30-48), and the mean MDP score was 15.87 (range, 10-18). Radiological evaluations showed full osseointegration of all stems.

Conclusion: This HAC-coated femoral stem has shown excellent survivorship, functional outcomes, and full osseointegration at the final follow-up.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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