用于全髋关节置换术的DePuy Proxima™短柄假体——至少7年的出色疗效。

The DePuy Proxima™ short stem for total hip arthroplasty - Excellent outcome at a minimum of 7 years.

作者信息

Gombár Csaba, Janositz Gábor, Friebert Gábor, Sisák Krisztián

机构信息

1 Department of Orthopaedics, University of Szeged, Szeged, Hungary.

2 Department of Orthopaedics, Bacs-Kiskun District General Hospital, Kecskemét, Hungary.

出版信息

J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019838668. doi: 10.1177/2309499019838668.

DOI:10.1177/2309499019838668

PMID:30939986

Abstract

PURPOSE

Metaphyseal, proximally anchored uncemented stems for total hip arthroplasty provide bone preservation and decrease the incidence of proximal stress shielding and thigh pain. Our study investigated the clinical and radiological outcome of the DePuy Proxima™ short stem at a minimum of 7 years.

METHODS

Eighty-one consecutive patients (86 procedures) under the age of 70 undergoing primary total hip replacement at two arthroplasty centres were enrolled. Follow-up was clinical (Harris Hip Score (HHS), thigh pain and satisfaction) and radiological (subsidence, malalignment and loosening) at 6 months and yearly thereafter.

RESULTS

Average age was 50 (range 32-65) with 79% (68 of 86) being male. Preoperative diagnosis included primary osteoarthritis (OA) 36%, avascular necrosis of femoral head 51%, dysplasia 9% and post-traumatic OA 4%. HHS improved 51 points at latest follow-up (from 40 to 91). We had 3.5% (3 of 86) periprosthetic fractures, one requiring revision. We had one dislocation, no infections and no thigh pain. Malalignment rate (≥5° off neutral) was 12% (10 of 86), not affecting clinical results.

CONCLUSION

Overall stem survival was over 97% at 7 years. The DePuy Proxima provides excellent clinical results at a minimum of 7 years post-operatively.

摘要

目的

用于全髋关节置换术的干骺端、近端固定的非骨水泥型股骨柄可保留骨质，并降低近端应力遮挡和大腿疼痛的发生率。我们的研究调查了DePuy Proxima™短柄股骨柄至少7年的临床和放射学结果。

方法

纳入了两个关节置换中心81例（86次手术）年龄在70岁以下接受初次全髋关节置换术的连续患者。随访内容包括术后6个月及之后每年的临床指标（Harris髋关节评分（HHS）、大腿疼痛和满意度）和放射学指标（下沉、对线不良和松动）。

结果

平均年龄为50岁（范围32 - 65岁），男性占79%（86例中的68例）。术前诊断包括原发性骨关节炎（OA）36%、股骨头缺血性坏死51%、发育不良9%和创伤后OA 4%。在最近一次随访时，HHS提高了51分（从40分提高到91分）。我们有3.5%（86例中的3例）假体周围骨折，其中1例需要翻修。有1例脱位，无感染和大腿疼痛。对线不良率（偏离中立位≥5°）为12%（86例中的10例），未影响临床结果。