Chiu KH, Shen WY, Tsui
HF, Law SW
Department of Orthopaedics and Traumatology,The Chinese University of Hong Kong,
Prince of Wales Hospital, Hong Kong.
One hundred and twelve primary cemented Exeter total hip replacement (Howmedica, Hong Kong) were performed in 101 Chinese patients. The prosthesis has a collar-less, double-tapered, polished stem. Seventy-five hips in 68 patients were available for assessment. The average age at operation was 63.7 years and the most common diagnosis was avascular necrosis. The average follow-up duration was 10 years 3 months (range, 7 years 6 months to 14.0 years). The Harris score improved from an average of 39.8 preoperatively to 83.8 at the last follow-up visit. Stem subsidence within the cement mantle occurred in 9.3% of cases with no other evidence of loosening. Eight hips in seven patients were revised after 5.0 to 14.0 years because of loosening. The 10-year survival rate was 93.3%. Oversizing of the stem and incomplete cement mantle might account for loosening. Stems of a smaller size have been made available to this population and it is hoped that this will improve results. (Hong Kong j. orthop. surg. 2001;5(1):2-10)
Key Words: Arthroplasty, replacement, hip; Bone cements/therapeutic use; Follow-up studies; Hip prosthesis, Treatment outcome
一零一位中國病者的112髖關節接受骨水泥固定的Exeter全髖關節置換術。我們使用冇頸圈及兩側漸變細的磨光支干。此研究對68位病者的75個髖關節進行了術後檢查。病者平均年齡是63.7歲，最常見的診斷是股骨頭缺血性壞死。隨訪時間為7.5至 14.0 年，平均隨訪時間10.3年。 Harris 得分從術前的平均39.8分改善到最後一次隨訪的83.8分。支干在骨水泥覆蓋中下沉率為9.3%，但沒有發現支干鬆脫。7位病人的八個髖關節因術後5 至 14 年鬆脫，需要手術翻修。十年生存率為93.3%。支干尺寸過大及不完整的骨水泥覆蓋可能是鬆脫的成因。中國病者可以用較小的支干尺寸，希望這可以改善將來的手術效果。
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