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大直径金属对金属全髋关节置换术与 28mm 头全髋关节置换术之间无临床差异?

No clinical difference between large metal-on-metal total hip arthroplasty and 28-mm-head total hip arthroplasty?

机构信息

Department of Orthopaedic Surgery, Martini Hospital, Groningen, The Netherlands.

出版信息

Int Orthop. 2011 Dec;35(12):1771-6. doi: 10.1007/s00264-011-1233-7. Epub 2011 Mar 4.

DOI:10.1007/s00264-011-1233-7
PMID:21373801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3224629/
Abstract

PURPOSE

We aimed to test the claim of greater range of motion (ROM) with large femoral head metal-on-metal total hip arthroplasty.

METHODS

We compared 28-mm metal-on-polyethylene (MP) total hip arthroplasty with large femoral head metal-on-metal (MM) total hip arthroplasty in a randomised clinical trial. ROM one year postoperatively was determined in 50 patients. Mean head sizes were 28 mm (MP) and 48 mm (MM).

RESULTS

After one year, the large head MM group showed greater improvement in internal rotation (14 degrees) than the 28 mm group (seven degrees).There were no significant differences in the absolute values of postoperative internal rotation, external rotation, flexion, extension, abduction and abduction.

CONCLUSIONS

Absolute postoperative range of motion did not differ between the two groups. The improvement in internal rotation was greater after large femoral head metal-on-metal total hip arthroplasty. It is however questionable whether this difference is clinically relevant.

摘要

目的

我们旨在验证大直径金属股骨头金属对金属全髋关节置换术具有更大活动度的说法。

方法

我们在一项随机临床试验中比较了 28mm 金属对聚乙烯(MP)全髋关节置换术与大直径金属股骨头金属对金属(MM)全髋关节置换术。术后一年测量了 50 例患者的活动度。平均股骨头直径分别为 28mm(MP)和 48mm(MM)。

结果

术后一年,大头 MM 组的内旋改善(14 度)大于 28mm 组(7 度)。术后内旋、外旋、屈曲、伸展、外展和外展的绝对值无显著差异。

结论

两组术后的绝对活动度无差异。大头金属对金属全髋关节置换术后的内旋改善更大。然而,这种差异是否具有临床意义是值得怀疑的。

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本文引用的文献

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Range of motion of large head total hip arthroplasty is greater than 28 mm total hip arthroplasty or hip resurfacing.大头全髋关节置换术的活动范围大于28毫米全髋关节置换术或髋关节表面置换术。
Clin Biomech (Bristol). 2011 Mar;26(3):267-73. doi: 10.1016/j.clinbiomech.2010.11.001. Epub 2010 Nov 30.
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Do large heads enhance stability and restore native anatomy in primary total hip arthroplasty?大头是否能提高初次全髋关节置换术的稳定性并恢复原生解剖结构?
Clin Orthop Relat Res. 2011 Jun;469(6):1547-53. doi: 10.1007/s11999-010-1605-0.
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Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients.测量髋关节撞击症患者被动髋关节活动范围的手动测角计的有效性和重测信度。
BMC Musculoskelet Disord. 2010 Aug 31;11:194. doi: 10.1186/1471-2474-11-194.
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Do large femoral heads reduce the risks of impingement in total hip arthroplasty with optimal and non-optimal cup positioning?大头股骨是否会降低在最佳和非最佳杯置位的全髋关节置换术中撞击的风险?
Int Orthop. 2011 Mar;35(3):317-23. doi: 10.1007/s00264-010-0954-3. Epub 2010 Feb 17.
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Range of motion after stemmed total hip arthroplasty and hip resurfacing - a clinical study.柄型全髋关节置换术和髋关节表面置换术后的活动范围——一项临床研究。
Bull NYU Hosp Jt Dis. 2009;67(2):177-81.
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Variability in hip range of motion on clinical examination.临床检查中髋关节活动范围的变异性。
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Range of motion after total hip resurfacing.
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Metal-on-metal hip resurfacing compares favorably with THA at 2 years followup.在2年的随访中,金属对金属髋关节表面置换术与全髋关节置换术相比效果良好。
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Posterior versus lateral surgical approach for total hip arthroplasty in adults with osteoarthritis.成人骨关节炎患者全髋关节置换术的后路与外侧手术入路
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