Kinov Plamen, Radl Roman, Zacherl Maximilian, Leithner Andreas, Windhager Reinhard
Medical University of Graz, Graz, Austria.
Acta Orthop Belg. 2007 Oct;73(5):618-24.
Thigh pain has been consistently reported with cementless hip arthroplasty. The correlation between thigh pain and radiological findings and the clinical significance of thigh pain have not been studied in any detail. We carried out a retrospective study to analyse the performance of a proximally porous-coated cementless femoral component. Ninety-eight total hip arthroplasties were followed up clinically and radiologically for an average of 33 months (range: 12 to 64) after operation. The clinical results were good or excellent in 85 cases (87%). Thirteen patients (13%) reported thigh pain at latest follow-up. Subsidence of the stem was recorded in 10 cases, cortical thickening occurred in 14 hips (14%), and 17 hips (17%) presented proximal osteopenia. Proximally, radiolucent lines were observed in 11 cases. Thigh pain correlated with radiolucent lines, femoral thickening, fibrous fixation and stem migration. Bone remodelling was noted to continue even five years after implantation. Our observations demonstrated bone ingrowth in the majority of the cases and a low incidence of thigh pain. The correlation between radiological changes and thigh pain suggests implant micromotion and migration in some hips. Patients with thigh pain, changes in the proximal femur and progressive subsidence need further clinical and radiological follow-up.
无骨水泥型髋关节置换术后一直有大腿疼痛的报道。但大腿疼痛与放射学表现之间的相关性以及大腿疼痛的临床意义尚未得到详细研究。我们进行了一项回顾性研究，以分析近端多孔涂层无骨水泥股骨假体的性能。98例全髋关节置换术患者术后平均随访33个月（范围：12至64个月），进行临床和放射学检查。85例（87%）患者临床结果为良好或优秀。13例患者（13%）在最近一次随访时报告有大腿疼痛。记录到10例假体柄下沉，14髋（14%）出现皮质增厚，17髋（17%）出现近端骨质减少。近端观察到11例有透亮线。大腿疼痛与透亮线、股骨增厚、纤维固定和假体柄移位相关。即使在植入后五年仍观察到骨重塑在继续。我们的观察表明大多数病例有骨长入且大腿疼痛发生率低。放射学改变与大腿疼痛之间的相关性提示在一些髋关节中存在假体微动和移位。有大腿疼痛、股骨近端改变和进行性下沉的患者需要进一步的临床和放射学随访。
