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超短解剖型与超短非解剖型非骨水泥股骨柄近端加载短期结果比较

Short-Term Results of Ultra-Short Anatomic vs Ultra-Short Non-Anatomic Proximal Loading Uncemented Femoral Stems.

机构信息

The Joint Replacement Center, Ewha Womans University, Seonam Hospital, Seoul, Republic of Korea.

The Joint Replacement Center, Ewha Womans University, Mokdong Hospital, Seoul, Republic of Korea.

出版信息

J Arthroplasty. 2018 Jan;33(1):149-155. doi: 10.1016/j.arth.2017.07.042. Epub 2017 Aug 3.

Abstract

BACKGROUND

Question arises as to whether rigid fixation of ultra-short anatomic or ultra-short non-anatomic proximal loading uncemented femoral stem can be obtained without diaphyseal stem fixation. The purpose of this study is to compare the short-term clinical results, radiographic results, revision and survival rates, and complication rates of ultra-short anatomic versus ultra-short non-anatomic uncemented femoral stems.

METHODS

This study consisted of 50 patients (56 hips) in the ultra-short anatomic uncemented stem group (mean age 61.4 ± 14.7 years) and 50 patients (56 hips) in the ultra-short non-anatomic uncemented stem group (mean age 59.5 ± 15.2 years). The mean follow-up was 3.4 years (range 3-4) in the ultra-short anatomic stem group and 3.5 years (range 3-4) in the ultra-short non-anatomic stem group.

RESULTS

At the final follow-up, the mean Harris hip scores (92 vs 93 points), Western Ontario and McMaster Universities Osteoarthritis scores (16 vs 15 points), University of California at Los Angeles activity scores (6.5 vs 6.8 points), the incidence of thigh pain (0% vs 4%), revision rates (0% vs 4%), aseptic loosening rate (0% vs 2%), and complication rates (2% vs 4%) were not significantly different between 2 groups.

CONCLUSION

Both ultra-short anatomic and ultra-short non-anatomic proximal loading uncemented femoral stems obtained rigid fixation without diaphyseal stem fixation in the short-term follow-up. This finding suggests that an ultra-short anatomic uncemented femoral stem can be replaced with an ultra-short non-anatomic uncemented stem to reduce inventory of the femoral stems, and consequently reduce manufacturing and delivery cost of these femoral stems.

摘要

背景

目前存在这样的疑问,即不使用骨干固定是否可以获得超短解剖或超短非解剖近端加载非骨水泥股骨柄的刚性固定。本研究的目的是比较超短解剖型与超短非解剖型非骨水泥股骨柄的短期临床结果、影像学结果、翻修率和生存率以及并发症发生率。

方法

本研究包括超短解剖型非骨水泥股骨柄组 50 例(56 髋;平均年龄 61.4 ± 14.7 岁)和超短非解剖型非骨水泥股骨柄组 50 例(56 髋;平均年龄 59.5 ± 15.2 岁)。超短解剖型股骨柄组的平均随访时间为 3.4 年(范围 3-4 年),超短非解剖型股骨柄组为 3.5 年(范围 3-4 年)。

结果

末次随访时,超短解剖型组的 Harris 髋关节评分(92 分比 93 分)、安大略西部大学和麦克马斯特大学骨关节炎评分(16 分比 15 分)、加利福尼亚大学洛杉矶分校活动评分(6.5 分比 6.8 分)、大腿疼痛发生率(0%比 4%)、翻修率(0%比 4%)、无菌性松动率(0%比 2%)和并发症发生率(2%比 4%)在两组间无显著差异。

结论

在短期随访中,超短解剖型和超短非解剖近端加载非骨水泥股骨柄在不使用骨干固定的情况下均获得了刚性固定。这一发现表明,超短解剖型非骨水泥股骨柄可以被超短非解剖型非骨水泥股骨柄所替代,以减少股骨柄的库存,从而降低这些股骨柄的制造成本和交付成本。

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