Jerosch J, Grasselli C, Kothny P C, Litzkow D, Hennecke T
Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Johanna-Etienne-Krankenhaus, Neuss.
Z Orthop Unfall. 2012 Feb;150(1):20-6. doi: 10.1055/s-0030-1270965. Epub 2011 Apr 12.
The purpose of the study was to analyse different parameters before and after implantation of a modern short-stem hip design.
In this prospective radiological study 250 consecutive hips with degenerative hip osteoarthritis were included (246 patients). The patients were operated by five different surgeons at 4 different hospitals and a metadiaphysial fixed short-stem prothesis (Mini Hip, Corin) was used. Standardised X-rays were performed with the same technique pre- and postoperatively in all patients. Different anatomic parameters of the hip were documented by using the pre- and postoperative Xrays (ofset, CCD angle, length of leg). All measurements were performed by an independent examiner. The 246 patients included 129 females and 117 males. The average age of the patients was 59.7 years (range: 27-82 years).
The offset only changed by + 0.28 cm (SD: 0.45 cm) after surgery. We could document only a small decrease of -0.51° (SD: 4.10°) of the CCD angle. The length of the leg increased on average by + 0.09 cm (SD: 0.34 cm). We found no difference between the measurements of female and male patients. Conspicuous was also the increasing use of small protheses (size 2) for hips with a small CCD angle and the increasing implantation of large protheses (size 9) in hips with a high CCD angle.
Our results showed that we could reconstruct the individual geometry of the hip quite well by using the metadiaphysial short-stem prothesis. The tendency of an increasing CCD angle and a decrease of the offset seems not to be existent with the design of this kind of short-stem prothesis.
本研究旨在分析现代短柄髋关节假体植入前后的不同参数。
在这项前瞻性放射学研究中,纳入了250例连续性退行性髋关节骨关节炎患者的髋关节(246例患者)。患者由4家不同医院的5位不同外科医生进行手术,并使用了一种干骺端固定短柄假体(Mini Hip,Corin)。所有患者术前和术后均采用相同技术进行标准化X线检查。通过术前和术后的X线片记录髋关节的不同解剖参数(偏心距、颈干角、腿长)。所有测量均由一名独立检查者进行。246例患者中,女性129例,男性117例。患者的平均年龄为59.7岁(范围:27 - 82岁)。
术后偏心距仅增加了+0.28 cm(标准差:0.45 cm)。我们仅记录到颈干角有-0.51°(标准差:4.10°)的微小减小。腿长平均增加了+0.09 cm(标准差:0.34 cm)。我们发现女性和男性患者的测量结果之间没有差异。同样值得注意的是,对于颈干角较小的髋关节,小号假体(2号)的使用越来越多;而对于颈干角较大的髋关节,大号假体(9号)的植入越来越多。
我们的结果表明,使用干骺端短柄假体能够很好地重建髋关节的个体几何结构。对于这种短柄假体的设计,颈干角增大和偏心距减小的趋势似乎并不存在。