Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, The University of Fukui, Matsuoka Shimoaizuki 23, Eiheiji, Fukui, Japan.
Artif Organs. 2010 May;34(5):377-83. doi: 10.1111/j.1525-1594.2009.00877.x.
Using a nonlinear three-dimensional finite element analysis simulating loading conditions, we designed a new type of proximal-fitting, anterolaterally-flared, arc-deposit hydroxyapatite-coated anatomical femoral stem (FMS-anatomic stem; Japan Medical Materials, Osaka, Japan) for cementless total hip arthroplasty (THA) for Japanese patients with dysplastic hip osteoarthritis. The aim of the present study was to analyze the clinical and radiographic outcomes of the new stem. We reviewed 143 consecutive patients (164 hips; 13 men, 14 hips; 130 women, 150 hips; age at surgery, 56.6 +/- 7.6 years, mean +/- SD, range, 30-74) who underwent cementless THA using the FMS-anatomic stem at a single institution, with a follow-up period of 7.6 +/- 1.6 years (range, 5.3-11.0). Harris Hip score improved from 46.1 +/- 12.6 before surgery to 90.0 +/- 8.9 points post-THA. The 7.6-year survival rate of the stem was 99.0% after revision for aseptic loosening. Radiographs at follow-up confirmed the stability of the femoral stems within the femoral canal in all cases, with sufficient bone ingrowth. None of the patients had subsidence of the stem exceeding 2.0 mm within the femoral canal or changes in varus or valgus position of more than 2.0 degrees . The FMS-anatomic stem provided excellent results in patients with dysplastic hip osteoarthritis. Our analysis confirmed reduced radiolucency around the stem in Gruen zones, minimal subsidence, appropriate stress shielding, and promising medium-term stability within the femoral canal in our patients.
使用非线性三维有限元分析模拟加载条件，我们为日本发育性髋关节骨关节炎患者设计了一种新型的非骨水泥全髋关节置换术用近端匹配、前外侧外展、弧形沉积羟基磷灰石涂层解剖股骨柄（FMS 解剖柄；日本医用材料，大阪，日本）。本研究旨在分析新柄的临床和影像学结果。我们回顾了 143 例连续患者（164 髋；13 例男性，14 髋；130 例女性，150 髋；手术时年龄，56.6 +/- 7.6 岁，平均值 +/- SD，范围 30-74），在一家机构接受了 FMS 解剖柄的非骨水泥全髋关节置换术，随访时间为 7.6 +/- 1.6 年（范围 5.3-11.0）。髋关节评分从术前的 46.1 +/- 12.6 提高到术后的 90.0 +/- 8.9 分。在因无菌性松动而进行翻修后，柄的 7.6 年生存率为 99.0%。随访时的 X 线片确认了所有病例股骨柄在股骨髓腔内的稳定性，有足够的骨长入。没有患者的股骨柄在股骨髓腔内下沉超过 2.0 毫米，也没有发生超过 2.0 度的内翻或外翻变化。FMS 解剖柄为发育性髋关节骨关节炎患者提供了良好的结果。我们的分析证实了我们患者的股骨髓腔内的柄周围的放射性透光区减少、下沉最小、适当的应力屏蔽以及有希望的中期稳定性。
