Mumme T, Friedrich M J, Andereya S, Müller-Rath R, Gravius S
Klinik für Orthopädie, Uniklinik RWTH Aachen.
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Rheinische Friedrich-Wilhelms-Universität Bonn.
Z Orthop Unfall. 2014 Oct;152(5):504-9. doi: 10.1055/s-0034-1383085. Epub 2014 Oct 14.
Conventional uncemented femoral stems provide good long-term fixation in patients with a wide range of clinical function. However, preservation of bone stock, and minimally invasive approaches have led to exploration into various other implant designs. Short-stem prosthesis focusing on a stable metaphyseal fit have emerged to address these challenges in total hip arthroplasty. The purpose of this study was to evaluate the clinical and radiological results of a newly developed short-stem hip prosthesis AIDA® in context of a single surgeon study.
From February 2009 to December 2013, 72 cementless "AIDA® short stems" (Fa. Implantcast) were implanted by a single surgeon in one study centre via the Watson Jones interval. All patients signed informed consent prior to screening and the study design was approved by the local ethics committee. 51 patients with 52 implants (35 female, 36 male) with a follow-up > 24 months were included in this prospective, controlled clinical trial. The patients were pre- and postoperatively examined clinically and radiological by a specified protocol.
The average patient age at the time of THA was 61 ± 3.2 years (min.-max. 46-68 years). At the last follow-up, the average Harris Hip score increased from 41.4 ± 4.5 preoperatively to 96.8 ± 3.2 points postoperatively. The hospital stay was 9.1 days on average. The X-rays showed in all cases a stable fixation of the stems with full bony integration and no signs of loosening or migration. There were no specific complications relating to the less invasive approach. Postoperatively one periprosthetic fracture was evident. The revision operation into a cementless stem was done without any complications (revisions rate 1.9 %).
The newly developed "AIDA short stem" is a promising hip implant for the young and active patient with osteoarthritis of the hip. The short-term results are encouraging, but nevertheless mid- and long-term results must be further observed on a prospective basis as part of this collective study.
传统非骨水泥型股骨柄在具有广泛临床功能的患者中能提供良好的长期固定效果。然而，为了保留骨量以及采用微创方法，人们开始探索各种其他的植入物设计。专注于稳定干骺端匹配的短柄假体应运而生，以应对全髋关节置换术中的这些挑战。本研究的目的是在一项单中心研究中评估新开发的短柄髋关节假体AIDA®的临床和影像学结果。
2009年2月至2013年12月，在一个研究中心，一名外科医生经沃森·琼斯间隙植入了72个非骨水泥型“AIDA®短柄”（Implantcast公司）。所有患者在筛查前均签署了知情同意书，研究设计获得了当地伦理委员会的批准。本前瞻性对照临床试验纳入了51例患者的52个植入物（女性35例，男性36例），随访时间超过24个月。按照特定方案对患者进行术前和术后的临床及影像学检查。
全髋关节置换术时患者的平均年龄为61±3.2岁（最小46岁，最大68岁）。在最后一次随访时，Harris髋关节平均评分从术前的41.4±4.5分提高到术后的96.8±3.2分。平均住院时间为9.1天。X线检查显示所有病例中柄均固定稳定，骨完全融合，无松动或移位迹象。与微创方法无关的特定并发症。术后可见1例假体周围骨折。翻修为非骨水泥柄的手术未出现任何并发症（翻修率1.9%）。
新开发的“AIDA短柄”对于年轻、活跃的髋关节骨关节炎患者是一种有前景的髋关节植入物。短期结果令人鼓舞，但作为本队列研究的一部分，仍必须前瞻性地进一步观察中长期结果。
