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VerSys髋关节系统(捷迈)非骨水泥型全髋关节置换术的中期临床结果

Mid-Term Clinical Results of VerSys Hip System (Zimmer) Uncemented Total Hip Replacement Arthroplasty.

作者信息

Kawaji Hidemi, Uematsu Takuya, Hoshikawa Naoya, Watanabe Hiroshi, Takai Shinro

机构信息

Department of Orthopaedic Surgery, Nippon Medical School.

出版信息

J Nippon Med Sch. 2016;83(5):184-187. doi: 10.1272/jnms.83.184.

Abstract

UNLABELLED

Recent reports suggest that uncemented total hip replacement arthroplasty (THR) results in favorable short- to mid-term clinical results. In the present study, we assessed the mid-term clinical results of VerSys Hip System uncemented THR at our hospital.

MATERIALS AND METHODS

We studied patients who received THR using VerSys Hip System and who could be followed-up more than 3 years. Clinical records were used to retrospectively identify patient characteristics, which included age, gender, disease requiring THR, preoperative and postoperative pain score of the Japan Orthopaedic Association scoring system, range of motion in flexion and abduction, operating time, intraoperative complication, and additional operation or revision surgery. Additionally, we investigated the loosening and alignment of implants from X-ray films.

RESULTS

Ninety-one patients and 108 hip joints were investigated. Subjects were 11 males and 97 females (mean age, 64.6 years). Mean follow-up period was 6.9 years. Reasons for requiring THR were as follows: secondary osteoarthritis, 87 joints; idiopathic osteonecrosis of the femoral head, 16 joints; rapidly destructive coxarthrosis, 4 joints; and idiopathic ossification of the labrum, 1 joint. Mean operating time was 166 minutes. A total of 11 intraoperative fractures occurred, and wiring was performed in 3 of those cases. Adverse events pertaining to the surgery were limited; however, another adverse event was that 1 case resulted in intraoperative perforation of femoral cortex, for which a revision surgery was performed. There was no dislocation. Pain score using the Japan Orthopaedic Association scoring system and range of motion tests showed statistically significant improvement following THR. At the final follow-up, although no loosening of femoral implants was observed, the loosening of acetabular component was seen in 1 case. Varus insertion of femoral implant was recognized in 40 joints. Moreover, the average inclination angle of acetabular implants was 52.2 degrees.

CONCLUSION

These data suggest that patients receiving VerSys Hip System uncemented THR demonstrate favorable results pertaining pain score and range of motion. However, high rate of intraoperative fracture and malalignment of implants, which may be at a risk of dislocation and/or polyethylene wear in future, suggests that this implant technique requires improvement.

摘要

未标注

近期报告显示,非骨水泥型全髋关节置换术(THR)在短期至中期临床效果良好。在本研究中,我们评估了我院使用VerSys髋关节系统进行非骨水泥型THR的中期临床效果。

材料与方法

我们研究了使用VerSys髋关节系统接受THR且随访时间超过3年的患者。利用临床记录回顾性确定患者特征,包括年龄、性别、需要进行THR的疾病、日本骨科协会评分系统的术前和术后疼痛评分、屈伸和外展活动范围、手术时间、术中并发症以及额外手术或翻修手术。此外,我们通过X线片研究了植入物的松动和对线情况。

结果

共调查了91例患者和108个髋关节。受试者中男性11例,女性97例(平均年龄64.6岁)。平均随访期为6.9年。需要进行THR的原因如下:继发性骨关节炎87个关节;股骨头特发性骨坏死16个关节;快速破坏性髋关节炎4个关节;以及盂唇特发性骨化1个关节。平均手术时间为166分钟。术中共发生11例骨折,其中3例进行了钢丝固定。与手术相关的不良事件有限;然而,另一不良事件是1例导致股骨皮质术中穿孔,为此进行了翻修手术。无脱位发生。使用日本骨科协会评分系统的疼痛评分和活动范围测试显示,THR后有统计学意义的改善。在最后随访时,虽然未观察到股骨植入物松动,但1例出现髋臼部件松动。40个关节发现股骨植入物内翻植入。此外,髋臼植入物的平均倾斜角度为52.2度。

结论

这些数据表明,接受VerSys髋关节系统非骨水泥型THR的患者在疼痛评分和活动范围方面显示出良好效果。然而,术中骨折和植入物排列不齐的发生率较高,这可能在未来有脱位和/或聚乙烯磨损的风险,提示这种植入技术需要改进。

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