Reducing the failure rate of hip resurfacing in dysplasia patients: a retrospective analysis of 363 cases

BMC Musculoskeletal Disorders

Research Article

Thomas P. Gross¹  Melissa D. Gaillard¹ 

[1] Midlands Orthopaedics & Neurosurgery PA, 1910 Blanding Street, Columbia, SC, USA;

关键词: Hip resurfacing;    Hip dysplasia;    Hip arthroplasty;    Hip replacement;    Metal-on-metal;    Adverse wear;   

DOI  :  10.1186/s12891-016-1095-7

 received in 2015-12-12, accepted in 2016-05-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundArthritis secondary to developmental hip dysplasia often mandates implant surgery at a relatively young age. Hip resurfacing arthroplasty (HRA), compared with standard stemmed total hip arthroplasty (THA), affords a more active lifestyle including extreme-motion activities but stimulates concerns pertaining to implant failure.MethodsWe addressed the primary modes of failure through a series of interventions, including a new guideline for achieving proper implant alignment through intraoperative x-rays. We then compared two sequential cohorts in a single-surgeon practice: patients with developmental dysplasia who underwent HRA before (Group 1; 121 hips in 105 patients) and after (Group 2; 242 hips in 210 patients) June 2008, at which time the four interventions were all in place.ResultsImplants in Group 2 failed less frequently within two years (0.8 % vs. 6.6 %, p = 0.002) and were more likely to have projected seven-year Kaplan-Meier survivorship (99 % vs. 89 %, p < 0.0001 by log-rank test). Patients in Group 2 were more likely to have normal metal ion levels (77 % vs. 56 %, p = 0.0008) and optimum metal ion levels (99 % vs. 86 %, p = 0.0008). Patients in Group 2 also benefited from a 19-min decrease in mean operation time, a 45 % decrease in mean estimated blood loss, and a 0.9-day decrease in mean hospital stay (p < 0.0001 in each instance).ConclusionsWe believe the interventions reported here, combined with sufficient surgeon experience and properly designed implants, afford patients with mild developmental dysplasia a more active lifestyle with favorable implant survival.

【 授权许可】

CC BY   
© The Author(s). 2016