Department of Orthopaedics, South Warwickshire NHS Foundation Trust, Warwick Hospital, Warwick, UK.
Bone Joint J. 2018 Dec;100-B(12):1559-1564. doi: 10.1302/0301-620X.100B12.BJJ-2018-0368.R2.
Cementless femoral stems must be correctly sized and well-seated to obtain satisfactory biological fixation. The change in sound that occurs during impaction of the femoral broach is said to indicate good fit, but this has not been widely studied. We set out to find whether the presence or absence of these sound changes could predict correct sizing.
We recorded the sound generated during femoral broaching for 105 cementless total hip arthroplasties using the Corail stem. Four cases were excluded, leaving 101 recordings for analysis. There were 36 male patients and 65 female patients, with a mean age of 69.9 years (sd 12.3) and median body mass index (BMI) of 29 kg/m (interquartile range (IQR) 26 to 32). The recordings were analyzed to identify the frequencies of the sounds produced during impaction of the femoral broach.
The emergence of a low-frequency band of sound in the 1 kHz range, during the final femoral broaching, was a strong predictor of a well-sized implant stem. The frequency was related to femoral length, supporting our hypothesis that the sound arose from the bone itself.
The low-frequency sound generated during femoral broaching can be monitored spectrographically, its frequency can be predicted from femoral length, and it is a good predictor of appropriate stem sizing.
非骨水泥股骨柄必须正确匹配并充分固定，以获得满意的生物学固定。压入股骨扩孔锉时发出的声音变化据称表明了良好的适配，但这尚未得到广泛研究。我们旨在确定这些声音变化的存在与否是否可以预测正确的尺寸。
我们使用 Corail 柄记录了 105 例非骨水泥全髋关节置换术中股骨扩孔时产生的声音。排除了 4 例，留下 101 例记录进行分析。共有 36 名男性和 65 名女性患者，平均年龄为 69.9 岁（标准差 12.3），中位数体重指数（BMI）为 29kg/m²（四分位间距（IQR）26 至 32）。对记录进行了分析，以确定在压入股骨扩孔锉时产生的声音的频率。
在最后一次股骨扩孔过程中出现 1 kHz 范围内的低频带声音是植入物柄尺寸合适的有力预测指标。该频率与股骨长度有关，支持了我们的假设，即声音来自骨骼本身。
股骨扩孔时产生的低频声音可以进行频谱监测，其频率可以根据股骨长度进行预测，并且是适当的柄尺寸预测的良好指标。
