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全髋关节置换术中股骨头颈交界处的股骨头材料损失:股骨头大小、柄部材料和柄部偏移的影响。

Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset.

作者信息

Valente Giuseppe, Lanting Brent, MacDonald Steven, Teeter Matthew G, Van Citters Douglas, Howard James

机构信息

Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London Health Sciences Centre, University Hospital, London, ON, Canada.

Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

出版信息

Hip Int. 2019 Nov;29(6):647-651. doi: 10.1177/1120700018814473. Epub 2018 Nov 30.

Abstract

INTRODUCTION

Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces.

METHODS

A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included = 56 of the 28-mm heads and = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined.

RESULTS

There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters ( = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems ( = 0.79), and regular or high-offset stems ( = 0.95).

CONCLUSION

There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

摘要

引言

全髋关节置换术中头颈交界处的材料损失可能会导致不良临床症状和植入物失败。本研究的目的是定量研究在金属对聚乙烯承重表面的翻修植入物中,头部尺寸、柄部材料和柄部偏移量对单一耳轴设计的头颈锥度界面材料损失的影响。

方法

进行了一项翻修研究,以识别来自单一植入物/锥度设计且植入时间超过2年的所有28毫米和32毫米股骨头。这包括28毫米股骨头中的56个和32毫米股骨头中的23个。根据时间和头部长度将28毫米股骨头与32毫米股骨头进行匹配。使用坐标测量机确定最大线性腐蚀深度(MLD)。确定了头部直径、柄部材料和柄部偏移量在MLD方面的差异。

结果

各年龄、性别、BMI或植入时间组之间无差异。28毫米和32毫米匹配配对的头部直径在MLD方面无差异(P = 0.59)。钛或钴铬合金柄在MLD方面也无差异(P = 0.79),常规或高偏移量柄在MLD方面也无差异(P = 0.95)。

结论

在全髋关节置换术中,28毫米和32毫米匹配配对的股骨头、相似或混合合金耦合的股骨头柄结构以及常规或高偏移量柄在头颈交界处的股骨头MLD方面无统计学差异。

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