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Uncemented total hip arthroplasty for primary osteoarthritis in young patients: A mid-to long-term follow-up study from the Finnish Arthroplasty Register

机译:未粘接的全髋关节置换术治疗年轻患者的原发性骨关节炎:芬兰置换术注册机构的中长期随访研究

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Introduction ?The survival of total hip arthroplasties (THAs) has been considered to be poor in young patients. We evaluated the population-based survival of uncemented THA for primary osteoarthritis (OA) in patients under 55 years of age and the factors affecting survival. Methods ?The Finnish Arthroplasty Register was established in 1980. Between that year and 2003, 92,083 primary THAs were entered in the register, 5,607 of which were performed for primary OA in patients under 55 years of age. Using records from these 5,607 THAs, we selected uncemented femoral and acetabular components that had been used in more than 100 operations during the study period. Survival of both components (cup/stem) and their combinations were analyzed separately with the Kaplan-Meier analysis and the Cox regression model. Results ?All uncemented stems studied showed a survival rate of over 90% at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93– 97) survival rate even at 15 years. Overall survival of the extendedly porous-coated Lord Madréporique stem (p?=?0.003) and the proximally porous-coated Anatomic Mesh stem (p?=?0.0008) were poorer than that of the Biomet Bi-Metric stem. When endpoint was defined as stem revision for any reason, results were generally similar; there was no difference, however, between the survival rates of the Lord Madréporique stem and the Bi-Metric stem. Of the acetabular components, the Biomet Universal, the ABG Il and the Harris-Galante II cups showed?
机译:简介?年轻患者的全髋关节置换术(THA)的存活率很低。我们评估了55岁以下患者原发性骨关节炎(OA)的未胶结THA的人群生存率以及影响生存率的因素。方法:芬兰人工关节置换术注册于1980年。从2003年到2003年,共注册了92,083例原发性THA,其中5,607例针对55岁以下的原发性OA患者进行。使用来自这5607个THA的记录,我们选择了在研究期间已用于100多次手术的非骨水泥股骨和髋臼组件。使用Kaplan-Meier分析和Cox回归模型分别分析了这两种成分(杯/茎)及其组合的存活率。结果?研究的所有未骨水泥茎在10年后的存活率均超过90%。甚至在15年时,Biomet双度量标准茎的存活率仍为95%(95%CI 93–97)。延伸多孔涂层的LordMadréporique茎(p?=?0.003)和近侧多孔涂层的解剖网状茎(p?=?0.0008)的总生存期均比Biomet Bi-Metric茎差。当出于任何原因将端点定义为词干修订时,结果通常相似; Madréporique勋爵和Bi-Metric勋爵的成活率没有差异。在髋臼组件中,Biomet Universal杯,ABG II杯和Harris-Galante II杯在以无菌松动为终点的10年生存率≤90%。在13年时,Biomet Universal的相应存活率为94%(95%CI 91-97),对于以无菌松动为终点的Harris-Galante II杯,其相应的存活率为95%(95%CI 91-98)。 PCA Pegged多孔涂层无骨水泥杯的13年生存率很低,为68%(95%CI 59-78),无菌性松动为终点。但是,当将终点定义为任何修订版(包括更换衬垫)时,除Harris-Galante II外,所有品牌杯子的10年生存率均降至80%以下。解释:现代的第二代非骨水泥柄,具有近端圆周多孔涂层或HA涂层,似乎是年轻的原发性OA患者的不错选择。同样,在这些年轻患者中,现代压配合的多孔和HA涂层杯似乎对无菌性松动具有良好的耐受性。但是,班轮修订很普遍。因此,未加注量的杯子的存活率很低。在这个年轻活跃的患者群体中,聚乙烯磨损和金属外壳与聚乙烯衬里及其后代之间不利的锁定机制仍然令人担忧。

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