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采用粉末制造技术生产的短柄髋关节假体保留股骨颈:连续病例系列的中期结果

Femoral neck preservation with a short hip stem produced with powder manufacturing: mid-term results of a consecutive case series.

作者信息

Schiraldi Marco, Bondi Manuel, Renzi Brivio Lodovico

机构信息

Azienda Ospedaliera Nazionale Alessandria, Via Venezia 16, 15100, Alessandria, Italy.

Azienda Ospedaliera Carlo Poma, 46100, Mantua, MN, Italy.

出版信息

Eur J Orthop Surg Traumatol. 2019 May;29(4):801-806. doi: 10.1007/s00590-019-02381-y. Epub 2019 Jan 28.

Abstract

Stress shielding and thigh pain are not uncommon after cementless total hip arthroplasty (THA) using conventional hip stems. It has been postulated that short, neck-preserving stems may overcome these disadvantages of standard stems and, hence, further improve clinical outcome. The purpose of our retrospective study was to assess the mid-term performance of a neck-preserving hip stem for which, as of yet, no clinical results have been published. A population of 146 consecutive patients who received 152 neck-preserving stems over a 1.6-year period was retrospectively reviewed. Harris Hip Score (HHS) and the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) were collected, along with radiographic data. One hundred and forty-four THAs implanted in 136 patients were available for analysis. After a mean follow-up of 56 months, mean HHS and WOMAC improved significantly versus preoperative values. Aseptic loosening was not observed. Five-year survival with revision of any component for any reason as the endpoint was 99.3% (95% confidence interval, 95.2-99.9%). Excellent mid-term clinical and radiographic outcomes were observed with the study device. We attribute this to the metaphyseal fit in combination with retention of the femoral neck. However, our findings need to be confirmed by multicentre studies with larger patient samples.

摘要

在使用传统髋关节柄进行非骨水泥型全髋关节置换术(THA)后,应力遮挡和大腿疼痛并不少见。据推测,短柄、保留股骨颈的柄可能会克服标准柄的这些缺点,从而进一步改善临床效果。我们这项回顾性研究的目的是评估一种保留股骨颈的髋关节柄的中期性能,截至目前,尚无关于该柄的临床结果发表。回顾性分析了在1.6年期间连续接受152个保留股骨颈柄的146例患者。收集了Harris髋关节评分(HHS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)以及影像学数据。对136例患者植入的144个THA进行分析。平均随访56个月后,平均HHS和WOMAC较术前值显著改善。未观察到无菌性松动。以任何原因对任何组件进行翻修为终点的5年生存率为99.3%(95%置信区间,95.2 - 99.9%)。研究使用的器械观察到了优异的中期临床和影像学结果。我们将此归因于干骺端匹配以及股骨颈的保留。然而,我们的研究结果需要通过更大样本量的多中心研究来证实。

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