Yi Jemin, Han Kye Young, Nam Young Jun, Kim Keun Woo
Department of Orthopaedic Surgery, Kangwon National University College of Medicine, Chuncheon, Korea.
Hip Pelvis. 2016 Sep;28(3):142-147. doi: 10.5371/hp.2016.28.3.142. Epub 2016 Sep 30.
This study aimed to investigate the outcomes of modular neck-utilization in primary total hip arthroplasty (THA).
Thirty patients (34 hips) who had modular stem THA between April 2011 and January 2013 were evaluated. There were 19 men and 11 women with a mean age of 61.2 years at the time of surgery. There were 20 cases of osteonecrosis of femoral head, 7 cases of osteoarthritis, 6 cases of femur neck fracture, and 1 case of rheumatoid arthritis. No patients presented with anatomical deformity of hip. Patients were operated on using a modified Watson-Jones anterolateral approach. All patients underwent clinical and radiological follow-up at 6 weeks, 3, 6, and 12 months, and every year postoperatively. The mean duration of follow-up was 48.2 months (range, 39 to 59 months).
The average Harris hip score improved from 63.7 to 88.1 at the final follow-up. Radiographically, mean acetabular cup inclination was 45.3°(range, 36°-61°) and anteversion was 21.7°(range, 11°-29°). All were neutral-positioned stems except 5 which were varus-positioned stems. In only 3 cases (8.8%), varus or valgus necks were required. A case of linear femoral fracture occurred intraoperatively and 1 case of dislocation occurred at postoperative 2 weeks. No complications at modular junction were occurred.
Our study shows that the use of modular necks had favorable clinical and radiographic results. This suggests that the use of modular neck in primary THA without anatomical deformity is safe at a follow-up of 39 months.
本研究旨在探讨初次全髋关节置换术（THA）中模块化股骨颈的应用效果。
对2011年4月至2013年1月期间接受模块化柄THA的30例患者（34髋）进行评估。其中男性19例，女性11例，手术时平均年龄为61.2岁。股骨头坏死20例，骨关节炎7例，股骨颈骨折6例，类风湿关节炎1例。无髋关节解剖畸形患者。采用改良Watson-Jones前外侧入路进行手术。所有患者在术后6周、3个月、6个月、12个月以及每年进行临床和影像学随访。平均随访时间为48.2个月（范围39至59个月）。
末次随访时Harris髋关节平均评分从63.7提高至88.1。影像学检查显示，髋臼杯平均倾斜角为45.3°（范围36°-61°），前倾角为21.7°（范围11°-29°）。除5例为内翻柄外，其余均为中立位柄。仅3例（8.8%）需要使用内翻或外翻股骨颈。术中发生1例股骨线性骨折，术后2周发生1例脱位。模块化连接处未发生并发症。
我们的研究表明，模块化股骨颈的应用具有良好的临床和影像学效果。这表明在无解剖畸形的初次THA中使用模块化股骨颈在39个月的随访期内是安全的。
