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使用MINIMA短柄进行全髋关节置换:一项短期随访研究。

Total hip replacement using MINIMA short stem: A short-term follow-up study.

作者信息

Drosos Georgios I, Tottas Stylianos, Kougioumtzis Ioannis, Tilkeridis Konstantinos, Chatzipapas Christos, Ververidis Athanasios

机构信息

Orthopaedic Department, Democritus University of Thrace, University General Hospital of Alexandroupolis, Alexandroupolis 68100, Greece.

出版信息

World J Orthop. 2020 Apr 18;11(4):232-242. doi: 10.5312/wjo.v11.i4.232.

Abstract

BACKGROUND

Total hip replacement has become one of the most successful orthopaedic procedures. The length of the femoral stem constitutes one of the most important geometrical and mechanical features of the prosthesis. Several different implants are currently available but data are limited concerning the clinical results for some of these implants.

AIM

To report the short-term clinical and radiological results of a novel squared section, tapered design - with four conicity - short stem in total hip replacement.

METHODS

This is a retrospective study of a prospectively collected data using of MINIMA short stem in 61 consecutive patients with at least 1 year follow-up. The collected data included patients' demographics, type of arthritis, bone morphology, perioperative data, clinical results using Harris Hip Score, EuroQol (EQ-5D), pain score and satisfaction rate, complications and radiological results.

RESULTS

Total 61 patients were included in our study with a mean age of 56 years of age (range 25-73 years). The majority of them (68.6%) were women, thirty seven patients (56.9%) were less than 60 years of age and almost half of patients (45.1%) suffered from secondary osteoarthritis (hip dysplasia, osteonecrosis, .). The mean time of follow-up examination was 33.4 mo (2.8 years) with a range of 12-57 months (1-4.8 years). In 35 patients (56.9%) the follow-up examination was more than 3 years. No major complications such as revision, periprosthetic fracture, dislocation or infection were presented. Re-admission 90 d postoperatively or laterwas deemed unnecessary for any reason regarding the operation. Respectively, the mean pain score, mean Harris hip score, and mean EQ-5D were improved from 6.3, 58.7 and 77.3 preoperatively to 0.1, 95.1, and 79.8 postoperatively. The Satisfaction rate at the final follow-up was 9.9 (SD 0.3, range 8.0-10.0). All stems were classified as stable bone ingrowth and no radiolucent lineswere revealed in any of the modified Gruens' zone at the postoperative X-rays. Stem subsidence was within acceptable limits and the incidence of distal cortical hypertrophy was relatively low.

CONCLUSION

The clinical and radiological results concerning the MINIMA short stem are excellent according to this first report of this specific design of the short femoral stems. Because of the small number of cases and short-term follow-up of this study, a longer follow up time and more patients' enrollment is required.

摘要

背景

全髋关节置换术已成为最成功的骨科手术之一。股骨柄的长度是假体最重要的几何和力学特征之一。目前有几种不同的植入物,但其中一些植入物的临床结果数据有限。

目的

报告一种新型方形截面、锥形设计(具有四种锥度)的短柄全髋关节置换术的短期临床和放射学结果。

方法

这是一项回顾性研究,对连续61例使用MINIMA短柄且至少随访1年的前瞻性收集数据进行分析。收集的数据包括患者的人口统计学信息、关节炎类型、骨形态、围手术期数据、使用Harris髋关节评分、欧洲五维度健康量表(EQ-5D)、疼痛评分和满意度的临床结果、并发症以及放射学结果。

结果

我们的研究共纳入61例患者,平均年龄56岁(范围25 - 73岁)。其中大多数(68.6%)为女性,37例患者(56.9%)年龄小于60岁,近一半患者(45.1%)患有继发性骨关节炎(髋关节发育不良、骨坏死等)。平均随访时间为33.4个月(2.8年),范围为12 - 57个月(1 - 4.8年)。35例患者(56.9%)的随访时间超过3年。未出现翻修、假体周围骨折、脱位或感染等重大并发症。术后90天或更晚因手术相关原因再次入院被认为不必要。术前平均疼痛评分、平均Harris髋关节评分和平均EQ-5D分别为6.3、58.7和77.3,术后分别改善至0.1、95.1和79.8。最终随访时的满意度为9.9(标准差0.3,范围8.0 - 10.0)。所有柄均归类为稳定的骨长入,术后X线片在任何改良Gruens区均未显示透光线。柄的下沉在可接受范围内,远端皮质肥大的发生率相对较低。

结论

根据这份关于这种特定设计的短股骨柄的首次报告,MINIMA短柄的临床和放射学结果非常出色。由于本研究病例数量少且随访时间短,需要更长的随访时间和更多的患者入组。

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