The Joint Replacement Institute, St Vincent Medical Center, 2200 West Third Street, Suite 400, Los Angeles, California 90057, USA.
J Orthop Res. 2010 Dec;28(12):1665-70. doi: 10.1002/jor.21176.
The theoretical advantage of using thinner acetabular components in hip resurfacing has not yet been clinically verified. Our purpose was to test the hypothesis of bone conservation and assess the effects of using a thinner acetabular component on hip biomechanics and clinical outcome. We compared the bone conservation, biomechanical results, and functional outcomes between hips in 35 patients who received bilateral metal-on-metal resurfacing arthroplasties with acetabular components of 5 mm thickness on one side and 3.5 mm thickness on the other. Acetabular abduction angle and acetabular anteversion were measured using Ein-Bild-Röentgen-Analysis software. Medial acetabular wall thickness and position of the hip center of rotation were measured using Image J software. The change in position of the hip center of rotation was minimal and did not reach significance. Thin-shelled components showed greater bone conservation on the acetabular side measured by an increase in the medial acetabular wall thickness. Bone conservation on the femoral side was achieved as well with thin shells. Range of motion, pain scores, and complication rates were comparable. No appreciable difference was found in bone-cup radiographic appearance between the two types of components. These data suggest that patients can experience good clinical outcomes for resurfacing with either thin or thick-shelled acetabular components. However, thin-shelled components preserve acetabular bone stock and allow the use of a larger femoral component. The use of thinner acetabular components is an improvement in bone conservation for a hip resurfacing design.
使用更薄的髋臼组件进行髋关节表面置换的理论优势尚未在临床上得到验证。我们的目的是检验保留骨量的假设，并评估使用更薄的髋臼组件对髋关节生物力学和临床结果的影响。我们比较了 35 例双侧金属对金属表面置换关节成形术患者的骨量保留、生物力学结果和功能结果，这些患者一侧的髋臼组件厚度为 5 毫米，另一侧为 3.5 毫米。使用 Ein-Bild-Röentgen-Analysis 软件测量髋臼外展角和髋臼前倾角。使用 Image J 软件测量髋臼内侧面厚度和髋关节旋转中心位置。髋关节旋转中心位置的变化很小，没有达到显著性。薄壳组件在髋臼侧表现出更好的骨量保留，表现为髋臼内侧面厚度增加。薄壳也可以实现股骨侧的骨量保留。活动度、疼痛评分和并发症发生率相当。两种类型的组件在骨杯的影像学表现上没有明显差异。这些数据表明，患者可以从薄壳或厚壳髋臼组件的表面置换中获得良好的临床结果。然而，薄壳组件保留了髋臼骨量，并允许使用更大的股骨组件。使用更薄的髋臼组件是髋关节表面置换设计在保留骨量方面的改进。
