Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
J Arthroplasty. 2012 Sep;27(8):1538-43. doi: 10.1016/j.arth.2012.01.031. Epub 2012 Mar 14.
To evaluate the effects of distal design of a proximally coated femoral component on periprosthetic bone remodeling, we prospectively performed 21 one-stage bilateral total hip arthroplasties using a distally tapered and a distally cylindrical stem with the same proximal design, randomized to side. All hips showed good outcomes clinically and radiographically at the final follow-up, average of 7 years postoperatively. Cancellous condensation was always found in Gruen's zones 2 and 6 around the cylindrical stem and in regions between zones 2 and 3 and between zones 6 and 5 around the tapered stem. Bone mineral density of Gruen's zones 2 and 6 was significantly lower around the tapered stem. These results suggested more distal loading in hips with the tapered stem than in those with the cylindrical stem.
为了评估近端涂层股骨部件的远端设计对假体周围骨重塑的影响，我们前瞻性地对 21 例双侧一期全髋关节置换术患者进行了研究，使用了具有相同近端设计的远端锥形和远端圆柱形柄，随机分组。所有髋关节在最终随访时均表现出良好的临床和影像学结果，平均术后 7 年。在圆柱形柄周围的Gruen 区域 2 和 6 以及区域 2 和 3 之间以及区域 6 和 5 之间总是发现松质骨凝聚。在锥形柄周围的Gruen 区域 2 和 6 的骨密度明显较低。这些结果表明，在使用锥形柄的髋关节中，远端负荷比使用圆柱形柄的髋关节更大。
