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导航与非导航全髋关节置换术:使用非骨水泥直柄髋关节假体的两个连续系列的结果

Navigated and nonnavigated total hip arthroplasty: results of two consecutive series using a cementless straight hip stem.

作者信息

Mainard Didier

机构信息

Centre Hospitalier Universitaire Nancy, France. Nancy, France.

出版信息

Orthopedics. 2008 Oct;31(10 Suppl 1).

Abstract

The purpose of this study was to compare conventional and navigated technique and a recently developed straight hip stem for uncemented primary total hip arthroplasty. The results of two consecutive implantation series of 42 patients (nonnavigated) and 42 patients (navigated) were analysed for implant positioning and complications. All surgeries were performed by the investigator. Radiographic analysis of cup position showed a significant improvement with reduced radiologic inclination (53 degrees nonnavigated /44 degrees navigated; P < .001) and higher anteversion (7 degrees nonnavigated /12 degrees navigated; P <.001). The mean postoperative limb length difference was 6.2 mm (SD, 9.0 for nonnavigated) and 4.4 mm (SD, 6.4 for navigated). Intraoperative and early postoperative complications were not different. No dislocation occurred in either group. There was one intraoperative trochanter fracture that was not revised (nonnavigated) and one revision because of a periprosthetic fracture caused by fall down during rehabilitation (navigated). We conclude that acetabular implant positioning can be significantly improved by the use of navigated surgery technique. The data for postoperative limb length difference were still similar but within the expected range in both groups. The effect of improved cup positioning on mid and longterm results for both groups has to be investigated further.

摘要

本研究的目的是比较传统技术与导航技术以及一种最近开发的用于非骨水泥型初次全髋关节置换术的直柄髋关节假体。对连续两个植入系列的42例患者(非导航组)和42例患者(导航组)的植入物定位和并发症结果进行了分析。所有手术均由研究者完成。髋臼位置的影像学分析显示,放射学倾斜度降低(非导航组53度/导航组44度;P <.001)且前倾角增加(非导航组7度/导航组12度;P <.001),有显著改善。术后肢体长度平均差异在非导航组为6.2 mm(标准差9.0),在导航组为4.4 mm(标准差6.4)。术中及术后早期并发症无差异。两组均未发生脱位。非导航组有1例术中转子骨折未进行翻修,导航组有1例因康复期间跌倒导致假体周围骨折而进行了翻修。我们得出结论,使用导航手术技术可显著改善髋臼植入物的定位。两组术后肢体长度差异的数据仍相似,但均在预期范围内。髋臼定位改善对两组中长期结果的影响有待进一步研究。

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