Division of Orthopaedic Surgery, Department of Surgery, St Michael's Hospital, University of Toronto, 800, 55 Queen Street East, Toronto, Ontario M5C1R6, Canada.
Clin Orthop Relat Res. 2011 Jun;469(6):1621-6. doi: 10.1007/s11999-010-1607-y.
Femoral neck fracture in hip resurfacing has been attributed to technical error during femoral head preparation. In the absence of fracture, several radiographic findings have been speculated to increase the risk of femoral component failure.
QUESTIONS/PURPOSES: We examined whether (1) the use of navigation to reduce technical errors during femoral head preparation reduces the incidence of femoral neck fractures in the short-term followup period; and (2) alignment of the femoral component with the use of computer navigation reduces the incidence of femoral neck thinning, femoral stem radiolucencies, and stem migration.
We retrospectively reviewed the first 100 Birmingham Hip Resurfacings performed in 94 prospectively followed patients between October 2005 and November 2007. We examined all radiographs on last followup. Eighty-six patients of the 94 patients had a minimum followup of 2 years (mean, 2.5 years; range, 2-4.1 years).
There were no cases of femoral neck notching, varus femoral component alignment, or femoral neck fractures in the series. Neck thinning of greater than 10% was observed in three patients and perimetaphyseal stem lucencies were noted in 10 patients. In three patients, the metaphyseal stem showed varus migration relative to the postoperative stem-shaft angle at latest followup. There was one revision to a total hip arthroplasty for deep sepsis. The overall survivorship at 4 years was 99%.
The use of imageless computer navigation to reduce technical errors in hip resurfacing may reduce the incidence of femoral neck fracture in the short-term. However, neck thinning, stem radiolucencies, and stem migration remain radiographic sequelae of hip resurfacing despite the use of navigation for placement of the femoral component.
髋关节表面置换术中股骨颈骨折归因于股骨头准备过程中的技术误差。在没有骨折的情况下，一些影像学发现被推测会增加股骨部件失效的风险。
问题/目的：我们检查了（1）使用导航来减少股骨头准备过程中的技术误差是否会降低短期随访期间股骨颈骨折的发生率；以及（2）股骨部件的对准是否会降低股骨颈变薄、股骨柄透亮和柄迁移的发生率。
我们回顾性分析了 2005 年 10 月至 2007 年 11 月期间前瞻性随访的 94 例患者中的前 100 例 Birmingham Hip Resurfacing。我们检查了最后一次随访时的所有 X 光片。94 例患者中的 86 例患者的随访时间至少为 2 年（平均 2.5 年；范围，2-4.1 年）。
在该系列中，没有股骨颈切迹、股骨部件内翻对线或股骨颈骨折的病例。有 3 例患者出现大于 10%的颈变薄，10 例患者出现近侧干骺端柄透亮。在 3 例患者中，在最新随访时，骨干骺端相对于术后柄干角出现了内翻迁移。有 1 例因深部感染行全髋关节翻修。4 年的总体生存率为 99%。
使用无图像计算机导航来减少髋关节表面置换术中的技术误差可能会降低短期股骨颈骨折的发生率。然而，尽管使用导航来放置股骨部件，颈变薄、柄透亮和柄迁移仍然是髋关节表面置换术的影像学后遗症。
