10年以上経過した Charnley THR の検討

抄録

we reviewed 52 cases (66 hips) of Charnley low friction arthroplasties which were followed for 10 to 20 years (average 12.4 years). Age at operation ranged from 33 to 77 years (average 54.9).
The average pre-operative and post operative JOA scores were 44.3 and 75.7 points respectively. The rate of revision surgery was 6% at 10 years and 35% at 15 years after primary total hip replacement. During this period of follow-up, problems such as deep infection (3 hips), dislocation (3 hips), femoral shaft fracture without loosening (2 hip), with loosening (1 hip), breakage of the stem (2 hips), breakage of the socket (2 hips) were found.
Potential failure and reoperation were needed in 14 patient, ten years after primary surgery due to mechanical causes. Of these 14 cases, five were stem components, eignt socket components and one involved both components. Causes of potential failure of the operation included over reaming of the acetabulum, varus position of the stem, existence of the pilot hole and aggressive granulomatous lesions of femoral bone.
In this follow-up series, patient age and socket angle were not associated factors.
Over reaming of the acetabulum was the principal cause of loosening, thereby resulting in poor results ten years after surgery.