Lee Gun-Woo, Park Kyung-Soon, Kim Do-Youn, Lee Young-Min, Eshnazarov Kamolhuja Eshnazarovich, Yoon Taek-Rim
Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Hwasun, Korea.
Department of Traumatology, Neurosurgery, and Military Field Surgery, Samarkand State Medical Institute, Samarkand, Uzbekistan.
Clin Orthop Surg. 2016 Mar;8(1):38-44. doi: 10.4055/cios.2016.8.1.38. Epub 2016 Feb 13.
Early stage osteonecrosis of the femoral head (ONFH) has many treatment options including core decompression with implantation of a tantalum rod. The purpose of this study was to evaluate clinical and radiological outcomes and potential complications during conversion total hip arthroplasty (THA) in such patients.
Six male patients (8 hips) underwent THA subsequent to removing a tantalum rod (group I) from April 2010 to November 2011. We retrospectively reviewed the medical records of these patients. We enrolled 12 age- and sex-matched patients (16 hips) during the same period, who had undergone primary THA without a previous operation as the control group (group II). All patients were followed for at least 3 years. We checked the Harris hip score (HHS), operative time, and volume of blood loss. Radiological results, including inclination, anteversion of the acetabular cup, presence of periprosthetic osteolysis, and subsidence of femoral stem were checked at the last follow-up.
The mean preoperative HHS values were 56.5 (range, 50 to 62) and 59.1 (range, 42 to 70) in groups I and II, respectively. The HHS improved to 96.0 (range, 93 to 100) and 97.6 (range, 93 to 100), respectively, at the 3-year follow-up (p = 0.172). Mean operation time was 98.8 minutes (range, 70 to 120 minutes) in group I and 77.5 minutes (range, 60 to 115 minutes) in group II (p = 0.006). Total blood loss volumes were 1,193.8 mL (range, 960 to 1,360 mL) and 944.1 mL (range, 640 to 1,280 mL) in groups I and II, respectively (p = 0.004). No significant differences in inclination or anteversion of acetabular cup and no evidence of osteolysis or subsidence of the femoral stem were reported in either group in radiological follow-up results. However, one case of squeaking occurred in group I during the follow-up.
The two groups showed no clinical or radiological differences except extended operative time and increased blood loss. However, the incidence of squeaking (1 of 8 hips) was higher, as compared to the control group or previously reported values.
早期股骨头坏死（ONFH）有多种治疗选择，包括钽棒植入的髓芯减压术。本研究的目的是评估此类患者在全髋关节置换术（THA）翻修过程中的临床和放射学结果以及潜在并发症。
2010年4月至2011年11月，6例男性患者（8髋）在取出钽棒后接受了THA（I组）。我们回顾性分析了这些患者的病历。同期纳入12例年龄和性别匹配的患者（16髋），他们接受了初次THA且未进行过先前手术作为对照组（II组）。所有患者均随访至少3年。我们检查了Harris髋关节评分（HHS）、手术时间和失血量。在最后一次随访时检查放射学结果，包括髋臼杯的倾斜度、前倾角、假体周围骨溶解的存在情况以及股骨柄的下沉情况。
I组和II组术前HHS的平均值分别为56.5（范围50至62）和59.1（范围42至70）。在3年随访时，HHS分别提高到96.0（范围93至100）和97.6（范围93至100）（p = 0.172）。I组平均手术时间为98.8分钟（范围70至120分钟），II组为77.5分钟（范围60至115分钟）（p = 0.006）。I组和II组的总失血量分别为1193.8 mL（范围960至1360 mL）和944.1 mL（范围6,40至1,280 mL）（p = 0.004）。放射学随访结果显示，两组髋臼杯的倾斜度或前倾角均无显著差异，且无股骨柄骨溶解或下沉的证据。然而，随访期间I组有1例出现吱吱声。
除了手术时间延长和失血量增加外，两组在临床和放射学上无差异。然而，与对照组或先前报道的值相比，吱吱声的发生率（8髋中的1髋）更高。
