使用短柄假体的全髋关节置换术：髋关节解剖结构的恢复

Total hip arthroplasty using a short-stem prosthesis: restoration of hip anatomy.

作者信息

Amenabar Tomas, Marimuthu Kanniraj, Hawdon Gabrielle, Gildone Alessandro, McMahon Stephen

机构信息

Malabar Orthopaedic Institute, The Avenue Hospital, Melbourne, Australia & Instituto Traumatológico de Santiago, Santiago, Chile.

Malabar Orthopaedic Institute, The Avenue Hospital, Melbourne, Australia.

出版信息

J Orthop Surg (Hong Kong). 2015 Apr;23(1):90-4. doi: 10.1177/230949901502300121.

DOI:10.1177/230949901502300121

PMID:25920653

Abstract

PURPOSE

To evaluate hip parameters such as vertical centre of rotation (VCR), horizontal centre of rotation (HCR), femoral offset, and leg length after total hip arthroplasty (THA) using the Nanos short-stem prosthesis.

METHODS

Medical records of 73 men and 74 women aged 25 to 92 (mean, 63) years who underwent THA using the Nanos short-stem prosthesis by a single surgeon were reviewed. Prior to the surgery, the optimal cup and stem size, head length, and level of the neck osteotomy were determined using radiographs. Intra-operatively, the leg length and femoral offset were checked, and the level of neck resection and head length were adjusted. VCR, HCR, femoral offset, and leg length of the operated and contralateral sides were compared. Functional outcomes were assessed using the Harris Hip Score (HHS).

RESULTS

Compared with the normal contralateral hips, the operated hips had a mean increase of 0.4 mm in VCR (p=0.032), a mean decrease of 1.4 mm in HCR (p=0.027), a mean increase of 0.6 mm in femoral offset (p=0.043), and a mean increase of 0.36 mm in leg length (p=0.035). For these respective parameters, the difference between the normal contralateral side and the operated side was within 5 mm in 89%, 80%, 71%, and 96% of patients. The HHS improved from a mean of 53 to 91 at one year (p<0.001).

CONCLUSION

THA using the Nanos short-stem prosthesis enabled restoration of hip anatomy (VCR, HCR, femoral offset, and leg length).

摘要

目的

使用纳米短柄假体评估全髋关节置换术（THA）后髋关节参数，如垂直旋转中心（VCR）、水平旋转中心（HCR）、股骨偏心距和腿长。

方法

回顾了由一名外科医生使用纳米短柄假体进行THA的73名男性和74名女性患者的病历，这些患者年龄在25至92岁（平均63岁）之间。术前，通过X线片确定最佳髋臼杯和假体柄尺寸、股骨头长度以及股骨颈截骨水平。术中，检查腿长和股骨偏心距，并调整股骨颈切除水平和股骨头长度。比较手术侧和对侧的VCR、HCR、股骨偏心距和腿长。使用Harris髋关节评分（HHS）评估功能结果。

结果

与正常对侧髋关节相比，手术侧髋关节的VCR平均增加0.4 mm（p = 0.032），HCR平均减少1.4 mm（p = 0.027），股骨偏心距平均增加0.6 mm（p = 0.043），腿长平均增加0.36 mm（p = 0.035）。对于这些参数，在89%、80%、71%和96%的患者中，正常对侧与手术侧之间的差异在5 mm以内。HHS在1年时从平均53分提高到91分（p<0.001）。