Garbuz Donald S, Toms Andrew, Masri Bassam A, Duncan Clive P
Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
Clin Orthop Relat Res. 2006 Dec;453:199-202. doi: 10.1097/01.blo.0000238875.86519.cf.
Many techniques have been advanced to achieve reliable femoral stem fixation in revision total hip arthroplasty. In a cross-sectional study, we compared quality of life in 220 patients with two femoral stem designs: a modular tapered and fluted titanium stem design and a cylindrical extensively coated chrome-cobalt stem with single modularity (head size and neck length alone). We matched cohorts based on age decade and gender. The minimum followup was 1 year with a median of 2 years. Subjective outcome assessment and patient satisfaction were measured using the WOMAC Osteoarthritis Index, the Oxford Hip Score, the SF-12, and the Arthroplasty Satisfaction Scale. At followup, all quality of life measures favored the tapered titanium stem. WOMAC pain, function, and overall scores all were higher in this group. The Oxford Hip Score and the Satisfaction score reflected a greater difference in outcome between the two stem designs. We presume reduced stiffness of the titanium stem, coupled with the intraoperative modularity, resulted in the improved patient outcomes observed in this study.
在翻修全髋关节置换术中，已经有许多技术被用于实现可靠的股骨柄固定。在一项横断面研究中，我们比较了220例使用两种股骨柄设计患者的生活质量：一种是模块化锥形带凹槽钛柄设计，另一种是具有单一模块化（仅头部尺寸和颈部长度）的圆柱形大面积涂层铬钴柄。我们根据年龄十年期和性别对队列进行匹配。最短随访时间为1年，中位数为2年。使用WOMAC骨关节炎指数、牛津髋关节评分、SF - 12和关节成形术满意度量表来测量主观结果评估和患者满意度。在随访时，所有生活质量指标都更有利于锥形钛柄。该组的WOMAC疼痛、功能和总体评分均更高。牛津髋关节评分和满意度评分反映了两种柄设计在结果上的更大差异。我们推测钛柄刚度的降低，加上术中的模块化，导致了本研究中观察到的患者结果改善。
