Abstract：
OBJECTIVE: To establish the survivorship, function, and metal ion levels in an unselected series of metal-on-metal hip resurfacing arthroplasties (HRAs) performed by a non-designer surgeon.
METHODS: We reviewed 105 consecutive HRAs in 83 patients, performed by a single surgeon, at a mean follow-up of 14.9 years (9.3 to 19.1). The cohort included 45 male and 38 female patients, with a mean age of 49.5 years (SD 12.5).
RESULTS: At the time of review 13 patients with 15 hips had died from causes unrelated to the hip operation, and 14 hips had undergone revision surgery, giving an overall survival rate of rate of 86.7% (95% confidence interval (CI) 84.2 to 89.1). The survival rate in men was 97.7% (95% CI 96.3 to 98.9) and in women was 73.4% (95% CI 70.6 to 75.1). The median head size of the failed group was 42 mm (interquartile range (IQR) 42 to 44), and in the surviving group was 50 mm (IQR 46 to 50). In all, 13 of the 14 revised hips had a femoral component measuring ≤ 46 mm. The mean blood levels of cobalt and chromium ions were 26.6 nmol/l (SD 24.5) and 30.6 nmol/l (SD 15.3), respectively. No metal ion levels exceeded the safe limit. The mean Oxford Hip Score was 41.5 (SD 8.9) and Harris Hip Score was 89.9 (14.8). In the surviving group, four patients had radiolucent lines around the stem of the femoral component, and one had lysis around the acetabular component; eight hips demonstrated heterotopic ossification.
CONCLUSIONS: Our results confirm the existing understanding that HRA provides good long-term survival and function in patients with adequate-sized femoral heads. This is evidenced by a 97.7% survival rate among men (larger heads) in our series at a mean follow-up of 14.9 years. Failure is closely related to head sizes ≤ 46 cm. Cite this article: Bone Jt Open 2022;3(1):68-76.
METHODS: We reviewed 105 consecutive HRAs in 83 patients, performed by a single surgeon, at a mean follow-up of 14.9 years (9.3 to 19.1). The cohort included 45 male and 38 female patients, with a mean age of 49.5 years (SD 12.5).
RESULTS: At the time of review 13 patients with 15 hips had died from causes unrelated to the hip operation, and 14 hips had undergone revision surgery, giving an overall survival rate of rate of 86.7% (95% confidence interval (CI) 84.2 to 89.1). The survival rate in men was 97.7% (95% CI 96.3 to 98.9) and in women was 73.4% (95% CI 70.6 to 75.1). The median head size of the failed group was 42 mm (interquartile range (IQR) 42 to 44), and in the surviving group was 50 mm (IQR 46 to 50). In all, 13 of the 14 revised hips had a femoral component measuring ≤ 46 mm. The mean blood levels of cobalt and chromium ions were 26.6 nmol/l (SD 24.5) and 30.6 nmol/l (SD 15.3), respectively. No metal ion levels exceeded the safe limit. The mean Oxford Hip Score was 41.5 (SD 8.9) and Harris Hip Score was 89.9 (14.8). In the surviving group, four patients had radiolucent lines around the stem of the femoral component, and one had lysis around the acetabular component; eight hips demonstrated heterotopic ossification.
CONCLUSIONS: Our results confirm the existing understanding that HRA provides good long-term survival and function in patients with adequate-sized femoral heads. This is evidenced by a 97.7% survival rate among men (larger heads) in our series at a mean follow-up of 14.9 years. Failure is closely related to head sizes ≤ 46 cm. Cite this article: Bone Jt Open 2022;3(1):68-76.
摘要：
目的：为了建立幸存者，函数,和金属离子水平在未经选择的一系列金属对金属髋关节表面置换术（HRA）由非设计外科医生进行。
方法：我们回顾了83例患者的105例连续HRA，由一名外科医生执行，平均随访14.9年（9.3至19.1年）。该队列包括45名男性和38名女性患者，平均年龄49.5岁（SD12.5）。
结果：在审查时，有13例15髋患者死于与髋关节手术无关的原因，14个臀部接受了翻修手术，总生存率为86.7%(95%置信区间(CI)84.2~89.1)。男性生存率为97.7%（95%CI96.3~98.9），女性生存率为73.4%（95%CI70.6~75.1）。失败组的中位头部大小为42mm（四分位距（IQR）42至44），在存活组中为50mm（IQR46至50）。总之,14个修订后的髋关节中有13个股骨组件的尺寸≤46mm。钴和铬离子的平均血液水平分别为26.6nmol/l（SD24.5）和30.6nmol/l（SD15.3），分别。没有金属离子水平超过安全限度。平均牛津髋关节评分为41.5（SD8.9），哈里斯髋关节评分为89.9（14.8）。在幸存的群体中，四名患者在股骨组件的茎周围有射线可透的线，一个髋臼周围有溶解；八个髋关节表现出异位骨化。
结论：我们的结果证实了现有的认识，即HRA在股骨头大小足够的患者中提供良好的长期生存和功能。在我们的系列中，平均随访14.9年，男性（大头）的生存率为97.7%。失效与头部尺寸≤46厘米密切相关。引用这篇文章：BoneJtOpen2022；3（1）：68-76。
方法：我们回顾了83例患者的105例连续HRA，由一名外科医生执行，平均随访14.9年（9.3至19.1年）。该队列包括45名男性和38名女性患者，平均年龄49.5岁（SD12.5）。
结果：在审查时，有13例15髋患者死于与髋关节手术无关的原因，14个臀部接受了翻修手术，总生存率为86.7%(95%置信区间(CI)84.2~89.1)。男性生存率为97.7%（95%CI96.3~98.9），女性生存率为73.4%（95%CI70.6~75.1）。失败组的中位头部大小为42mm（四分位距（IQR）42至44），在存活组中为50mm（IQR46至50）。总之,14个修订后的髋关节中有13个股骨组件的尺寸≤46mm。钴和铬离子的平均血液水平分别为26.6nmol/l（SD24.5）和30.6nmol/l（SD15.3），分别。没有金属离子水平超过安全限度。平均牛津髋关节评分为41.5（SD8.9），哈里斯髋关节评分为89.9（14.8）。在幸存的群体中，四名患者在股骨组件的茎周围有射线可透的线，一个髋臼周围有溶解；八个髋关节表现出异位骨化。
结论：我们的结果证实了现有的认识，即HRA在股骨头大小足够的患者中提供良好的长期生存和功能。在我们的系列中，平均随访14.9年，男性（大头）的生存率为97.7%。失效与头部尺寸≤46厘米密切相关。引用这篇文章：BoneJtOpen2022；3（1）：68-76。
