Abstract:
Hip resurfacing arthroplasty (HRA) has been advocated as an attractive therapy for a younger, more demanding patient population with debilitating hip osteoarthritis. Controversies surrounding metal-on-metal (MoM) hip resurfacing have, however, led to a significant decline in the popularity of the HRA. Despite this, substantial evidence supports the use of specific implants in a selected group of patients. This is a continued retrospective analysis of a single surgeon series of the Birmingham Hip Resurfacing (BHR). Initial medium-term analysis was done in 2011 and published by Van der Bracht et al.13. This analysis includes a long-term follow-up of 7 to 12 years, including functional scoring (HHS, HOOS and UCLA activity score), metal ion evaluation and survival analysis. Failure was defined as revision for any cause. A total of 267 resurfacing procedures with the BHR were included in 247 patients. We had a mean follow-up of 8.3 years. Overall survival at ten years was 94.8%(97.2% for males and 90.1% for females). There was a statistically significant increase in mean HHS score at follow-up (56.03 - IQR 47-65 to 96.07 - IQR 96-100). Elevated metal ions were correlated with a statistically significant increase in the probability of complications. This cohort study further proved that hip resurfacing arthroplasty with the Birmingham Hip Resurfacing implant provides a good alternative to conventional total hip arthroplasty in young patients. There was a significant increase in functional scores at follow-up. There is further evidence of less favorable outcomes in female patients.
摘要:
髋关节表面置换术(HRA)已被提倡为年轻人的一种有吸引力的疗法,更苛刻的患者人群与衰弱的髋关节骨关节炎。围绕金属对金属(MoM)髋关节表面重铺的争议,然而,导致HRA的受欢迎程度大幅下降。尽管如此,大量证据支持在选定的一组患者中使用特定的植入物。这是对伯明翰髋关节置换术(BHR)的单个外科医生系列的持续回顾性分析。最初的中期分析是在2011年完成的,由VanderBracht等人13发表。这项分析包括7至12年的长期随访,包括功能评分(HHS,HOOS和UCLA活动得分),金属离子评估和生存分析。失败被定义为任何原因的修订。在247例患者中,总共包括267例BHR的表面置换程序。我们平均随访了8.3年。10年总生存率为94.8%(男性为97.2%,女性为90.1%)。随访时平均HHS评分有统计学上的显着增加(56.03-IQR47-65至96.07-IQR96-100)。金属离子升高与并发症概率的统计学显着增加相关。这项队列研究进一步证明,采用伯明翰髋关节表面置换植入物的髋关节表面置换为年轻患者的常规全髋关节置换术提供了良好的替代方案。随访时功能评分显著增加。有进一步的证据表明女性患者的预后较差。