Nejvíce citovaný článek - PubMed ID 19214506
Risk factors for accelerated polyethylene wear and osteolysis in ABG I total hip arthroplasty
PURPOSE: The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of the Balgrist total hip replacement cup. METHODS: We report the results of a retrospective review of 195 total hip prostheses with Balgrist cup implanted in 178 patients. There were 59 men and 119 women with a mean age at surgery of 52.3 years (range, 19-72). Cox regression was used to determine the influence of independent variables on the survivorship of the prosthesis. RESULTS: There were 117 (66 %) of 178 patients, and 131 (67 %) of 195 hips available for assessment at a mean follow-up of 17.4 years. A total of 21 patients (22 hips) were lost from follow-up (12 %). A total of 25 patients (27 hips) required some type of re-operation during the follow-up period. Eight of 27 re-operations (30 %) were directly caused by the Balgrist cup failure due to fatigue fracture of the metallic shell (n = 5; 19 %), polyethylene wear (n = 2; 7 %) and aseptic loosening (n = 1; 4 %). The mean polyethylene wear rate was 0.068 mm/year (range, 0.008-0.230; SD = 0.043). The risk of re-operation for any reason was decreased with dysplastic hip as a primary diagnosis (hazard ratio; HR = 0.250; 95 % CI 0.086-0.725) and with greater age at the time of surgery (HR = 0.923; 95 % CI 0.880-0.969). The 19-year survivorship with re-operation for any reason was 75.6 % (95 % CI 67.0-84.2). The 19-year survivorship with re-operation for the Balgrist cup failure was 90.5 % (95 % CI 83.4-97.6). CONCLUSIONS: The Balgrist cup continues to provide excellent clinical and radiological outcomes. This is associated at least in part with a low polyethylene wear rate. The main reason for the Balgrist cup failure is fatigue fracture of the metallic shell.
- MeSH
- artróza kyčelních kloubů chirurgie MeSH
- dospělí MeSH
- incidence MeSH
- Kaplanův-Meierův odhad MeSH
- kohortové studie MeSH
- kostní cementy MeSH
- kyčelní kloub diagnostické zobrazování chirurgie MeSH
- kyčelní protézy * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- luxace kyčle chirurgie MeSH
- náhrada kyčelního kloubu přístrojové vybavení MeSH
- následné studie MeSH
- polyethylen MeSH
- proporcionální rizikové modely MeSH
- protézy - design * MeSH
- radiografie MeSH
- reoperace přístrojové vybavení statistika a číselné údaje MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- práce podpořená grantem MeSH
- Názvy látek
- kostní cementy MeSH
- polyethylen MeSH
BACKGROUND: We studied which factor could predict aseptic loosening in ABG I hip prosthesis with hydroxyapatite coating. Aseptic loosening and periprosthetic osteolysis are believed to be caused, at least in part, by increased polyethylene (PE) wear rate via particle disease. Based on it, increased PE wear rate should be associated with aseptic loosening regardless of the type of implant. METHODS: We analyzed data from 155 revisions of ABG I hip prostheses to examine the influence of patient, implant, surgery, and wear related factors on the rate of aseptic loosening at the site of the cup. This was calculated by stepwise logistic regression analysis. The stability of the implant and severity of bone defects were evaluated intraoperatively. RESULTS: We found that men (odds ratio, OR = 5.6; p = 0.004), patients with Charnley class C (OR = 6.71; p = 0.013), those having more severe acetabular bone defects (OR = 4 for each degree of severity; p = 0.002), and longer time to revision surgery (OR = 1.51 for each additional year; p = 0.012) had a greater chance of aseptic loosening of the cup. However, aseptic loosening was not directly predicted by polyethylene wear rate in our patients. CONCLUSION: Severity of bone defects predicts the risk for aseptic loosening in ABG I cup. Factors potentially associated with the quality of bone bed and biomechanics of the hip might influence on the risk of aseptic loosening in this implant.
- MeSH
- artróza kyčelních kloubů diagnostické zobrazování patologie chirurgie MeSH
- kyčelní kloub diagnostické zobrazování patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhrada kyčelního kloubu škodlivé účinky MeSH
- pooperační komplikace epidemiologie MeSH
- progrese nemoci MeSH
- radiografie MeSH
- rizikové faktory MeSH
- selhání protézy trendy MeSH
- senioři MeSH
- sexuální faktory MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH