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使用非骨水泥短柄假体进行髋关节置换术后的贴合与填充影响。

Influences of fit and fill following hip arthroplasty using a cementless short-stem prosthesis.

作者信息

Jahnke Alexander, Engl Sandra, Seeger Jörn Bengt, Basad Erhan, Rickert Markus, Ishaque Bernd Alexander

机构信息

Laboratory of Biomechanics, Justus-Liebig-University Giessen, Paul-Meimberg-Strasse 3, 35392, Giessen, Germany.

Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, 35392, Giessen, Germany.

出版信息

Arch Orthop Trauma Surg. 2015 Nov;135(11):1609-14. doi: 10.1007/s00402-015-2302-y. Epub 2015 Aug 14.

Abstract

INTRODUCTION

The purpose of this study consisted in examining the effects of fit and fill ratio of the Metha prosthesis (BBraun, Aesculap, Tuttlingen, Germany) on radiological and clinical outcomes at a follow-up of 1 year.

METHODS

40 patients were included. Fit and fill ratio measurements, radiological and clinical examinations were performed preoperatively and postoperatively. Correlations were established between fit and fill ratio, and potential factors like sex, age, body mass index, Harris Hip Score and changes of radiological signs.

RESULTS

The whole cohort (100%) had a tight fit and fill ratio (>0.8) at the proximal level and at each follow-up. "Champagne-flute" configuration provoked high distal tight-fit and fill ratio. Poor distal fit and fill ratio compared to the proximal and the mid-stem level was measurable at each follow-up (p < 0.05). Correlations between fit and fill ratio and preoperative femur configurations were detectable.

CONCLUSIONS

Implanting the Metha prosthesis induces tight fit and fill ratio at the proximal and coated sections. Preoperative femur configuration should be considered to achieve best fit and fill situation and therefore excellent primary stability. In most cases "normal" and "stove-pipe" configurations provide good proximal fit and fill. Since "champagne-flute" configuration induces undesirable tight distal fit and fill ratio the size of the Metha (®) stem should be adequately increased to achieve a more proximal load transmission.

摘要

引言

本研究的目的是在1年随访期内,检验梅塔假体(德国图特林根市贝朗医疗旗下蛇牌)的贴合度和填充率对影像学及临床结果的影响。

方法

纳入40例患者。在术前和术后进行贴合度和填充率测量、影像学及临床检查。建立贴合度和填充率与性别、年龄、体重指数、Harris髋关节评分及影像学征象变化等潜在因素之间的相关性。

结果

整个队列(100%)在近端水平及每次随访时均具有紧密贴合度和填充率(>0.8)。“香槟杯”构型导致远端紧密贴合度和填充率较高。每次随访时均可测量到,与近端和骨干中部水平相比,远端贴合度和填充率较差(p<0.05)。可检测到贴合度和填充率与术前股骨构型之间的相关性。

结论

植入梅塔假体可在近端和涂层部分实现紧密贴合度和填充率。应考虑术前股骨构型,以实现最佳贴合度和填充情况,从而获得优异的初始稳定性。在大多数情况下,“正常”和“烟囱管”构型可提供良好的近端贴合度和填充率。由于“香槟杯”构型会导致不理想的远端紧密贴合度和填充率,因此应适当增加梅塔(®)柄的尺寸,以实现更接近近端的负荷传递。

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