Hozumi Akira, Kobayashi Kyousuke, Tsuru Nobuhisa, Miyamoto Chikara, Maeda Jyunichiro, Chiba Ko, Goto Hisataka, Osaki Makoto
Department of Orthopaedic Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Biomed Res Int. 2015;2015:690539. doi: 10.1155/2015/690539. Epub 2015 Oct 25.
The S-ROM-A prosthesis has been designed for the Asian proximal femur with a small deformed shape and narrow canal. In this study, the clinical and radiological results using the S-ROM-A prosthesis for Japanese patients with severe deformity due to dysplasia and excessive posterior pelvic tilt were examined.
94 hips were followed up for a mean of 55 months, with a mean age at surgery of 61 years. The primary diagnoses were 94 coxarthritis cases, including 51 dysplasia and 37 primary OA, 1 avascular necrosis, 2 traumatic arthritis, and 3 Perthes disease. Thirty-one hips had been treated with osteotomy of the hip joints. Preoperative intramedullary canal shapes were stovepipe in 23 hips, normal in 51 hips, and champagne-flute in 5 hips. The maximum pelvic inclination angle was 56°.
The mean JOA score improved from 46 points preoperatively to 80 points at final follow-up. On radiological evaluation of the fixation of the implants according to the Engh classification, 92 (97%) hips were classified as "bone ingrown fixation."
In primary THA, using the S-ROM-A prosthesis for Asian patients with proximal femoral deformity, even after osteotomy and with posterior pelvic tilt, provided good short- to midterm results.
S-ROM-A假体是为亚洲近端股骨设计的,其形状变形小且髓腔狭窄。在本研究中,对使用S-ROM-A假体治疗因发育不良和骨盆后倾过度导致严重畸形的日本患者的临床和影像学结果进行了检查。
对94例髋关节进行了平均55个月的随访,手术时的平均年龄为61岁。主要诊断为94例髋关节炎病例,包括51例发育不良和37例原发性骨关节炎、1例缺血性坏死、2例创伤性关节炎和3例佩特兹病。31例髋关节接受了髋关节截骨术治疗。术前髓腔形状为烟囱状的有23例髋关节,正常的有51例髋关节,香槟杯状的有5例髋关节。最大骨盆倾斜角度为56°。
日本骨科学会(JOA)评分平均从术前的46分提高到末次随访时的80分。根据恩格分类法对植入物固定进行影像学评估,92例(97%)髋关节被归类为“骨长入固定”。
在初次全髋关节置换术中,对于亚洲近端股骨畸形患者,即使在截骨术后且存在骨盆后倾的情况下,使用S-ROM-A假体也能提供良好的短期至中期结果。