Morita Daigo, Seki Taisuke, Higuchi Yoshitoshi, Takegami Yasuhiko, Amano Takafumi, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Showa-ku, Japan.
Hip Int. 2018 Jul;28(4):369-374. doi: 10.1177/1120700018754308. Epub 2018 Apr 30.
This study investigates differences in femoral head penetration between highly cross-linked polyethylene (HXLPE) cemented sockets both with and without radiolucent lines (RLLs) in the early postoperative phase and at 5 years follow-up.
There were 35 patients (37 hips), mean age of 66.8 years, who underwent total hip arthroplasty (THA) using highly HXLPE cemented sockets. They were divided into 2 groups based on postoperative the early appearance of RLLs. Femoral head penetrations on both anteroposterior- and Lauenstein-view radiographs were evaluated, and the mean polyethylene (PE) wear rate was calculated based on femoral head penetrations between 2 and 5 years.
Femoral head penetrations in the proximal direction were 0.075 mm and 0.150 mm in the RLL and non-RLL groups at 1 year postoperatively ( p = 0.019). At 5 years measured penetration was 0.107 mm and 0.125 mm in the RLL and non-RLL groups, respectively ( p = 0.320). The mean PE wear rates in anteroposterior-view were 0.008 mm/year and 0.003 mm/year in the RLL and non-RLL groups ( p = 0.390) and those in Lauenstein-view were 0.010 mm/year and 0.005 mm/year, respectively ( p = 0.239).
In the RLL group, the PE bedding-in was less compared with those in the non-RLL group. Additionally, the mean PE wear rate in the RLL group tended to be higher than that in the non-RLL group. The distribution of stress loading through the cement may differ according to whether early RLLs appear.
本研究调查了在术后早期及5年随访时,有和没有射线可透性线(RLLs)的高交联聚乙烯(HXLPE)骨水泥固定髋臼杯之间股骨头穿透情况的差异。
35例患者(37髋),平均年龄66.8岁,接受了使用高HXLPE骨水泥固定髋臼杯的全髋关节置换术(THA)。根据术后早期RLLs的出现情况将他们分为2组。评估前后位和Lauenstein位X线片上的股骨头穿透情况,并根据2至5年之间的股骨头穿透情况计算平均聚乙烯(PE)磨损率。
术后1年,RLL组和非RLL组近端方向的股骨头穿透分别为0.075 mm和0.150 mm(p = 0.019)。在5年时,RLL组和非RLL组测得的穿透分别为0.107 mm和0.125 mm(p = 0.320)。前后位的平均PE磨损率在RLL组和非RLL组分别为0.008 mm/年和0.003 mm/年(p = 0.390),Lauenstein位分别为0.010 mm/年和0.005 mm/年(p = 0.239)。
在RLL组中,与非RLL组相比,PE的嵌入较少。此外,RLL组的平均PE磨损率倾向于高于非RLL组。根据早期RLLs是否出现,通过骨水泥的应力加载分布可能有所不同。