Department for Orthopedic Surgery and Traumatology, Buergerspital Solothurn, Schoengruenstrasse 42, 4500, Solothurn, Switzerland.
Department for Orthopedic Surgery and Traumatology, Inselspital, University of Bern, Bern, Switzerland.
BMC Musculoskelet Disord. 2019 Dec 12;20(1):604. doi: 10.1186/s12891-019-2980-7.
Early femoral stem subsidence following a cementless THA is correlated with aseptic loosening of the femoral component. The short femoral stems allow bone sparing and implantation through a minimally invasive approach; however, due to their metaphyseal anchoring, they might demonstrate different subsidence pattern than the conventional stems.
In this prospective single-center study, a total of 68 consecutive patients with an average age of 63 years, and a minimum follow-up of 5 years following a cementless THA with a metaphyseal-anchored short femoral stem were included. The femoral stem subsidence was evaluated using "Ein Bild Roentgen Analyse" (EBRA).
Average stem migration was 0.96 +/- 0.76 mm at 3 months, 1.71 +/- 1.26 mm at 24 months, and 2.04+/- 1.42 mm at last follow-up 60 months postoperative. The only factor that affected migration was a stem size of 6 or more (r = 5.74; p = 0.039). Subdivision analysis revealed, that only in females migration appeared to be affected by stem size irrespective of weight but not in men (female stem size of 6 or more vs. less (Difference = - 1.48 mm, R = 37.5; p = 0.001). Migration did not have an impact on clinical outcome measures.
The examined metaphyseal-anchored short femoral stem showed the highest subsidence within the first 3 months postoperative, the implant began to stabilize at about 24 months but continued to slowly migrate with average total subsidence of 2.04 mm at 5 years following the THA. The amount of stem subsidence was not associated with worse clinical outcomes such as HHS, patient satisfaction, or pain.
非骨水泥全髋关节置换术后早期股骨柄沉降与股骨部件的无菌性松动有关。短柄股骨允许通过微创入路进行骨保留和植入；然而，由于其在骨干的锚定，它们可能表现出与传统柄不同的沉降模式。
在这项前瞻性单中心研究中，共纳入了 68 例连续患者，平均年龄 63 岁，在接受非骨水泥全髋关节置换术并使用骨干锚定短柄股骨后，随访时间至少 5 年。使用“Ein Bild Roentgen Analyse”（EBRA）评估股骨柄沉降。
平均柄迁移在 3 个月时为 0.96 +/- 0.76 mm，在 24 个月时为 1.71 +/- 1.26 mm，在最后一次随访 60 个月时为 2.04 +/- 1.42 mm。唯一影响迁移的因素是柄的尺寸为 6 或更大（r = 5.74；p = 0.039）。细分分析显示，只有女性的迁移似乎受到柄尺寸的影响，而与体重无关，但在男性中则不然（女性柄尺寸为 6 或更大与更小（差值 = -1.48 mm，R = 37.5；p = 0.001）。迁移对临床结果测量没有影响。
所检查的骨干锚定短柄股骨在术后前 3 个月内沉降量最大，植入物在大约 24 个月时开始稳定，但仍继续缓慢迁移，全髋关节置换术后 5 年平均总沉降量为 2.04 mm。柄沉降量与较差的临床结果（如 HHS、患者满意度或疼痛）无关。
