Department of Trauma and Orthopaedics, University College London Hospitals NHS Trust, 250 Euston Road, London, NW1 2BU, UK.
Division of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium.
Arch Orthop Trauma Surg. 2021 Jun;141(6):1065-1071. doi: 10.1007/s00402-021-03778-3. Epub 2021 Jan 24.
A new fluted, titanium, monobloc stem with a three degree taper has been designed in an attempt to overcome the challenges associated with femoral reconstruction in the setting of extensive bone loss. The aim of this study was to report its early clinical and radiographic outcomes.
This is a retrospective review of prospectively collected data carried out at a single institution between Jan 2017 and Dec 2019. Forty-three femoral revisions were performed using a new tapered, fluted, titanium, monobloc (TFTM) revision stem. Complications, clinical and radiographic data were obtained from medical records and a locally maintained database. Clinical outcomes were assessed using the Oxford Hip Score (OHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). All post-operative radiographs were analysed for subsidence, osteolysis and femoral cortical bone remodelling.
Mean follow-up was 24 months (range 8-42 months). Subsidence of 1.2 mm was noted in one patient. No cases of clinically significant subsidence (> 10 mm) were observed. At final follow-up, a statistically significant improvement was noted in functional outcome scores. The mean OHS preoperatively and at final follow-up were 24 (SD 13) and 42 (SD15). p = 0.04 mean difference 18 (95% CI 15-22). The mean WOMAC scores preoperatively and at final follow-up were 62 (SD23) and 88 (SD7) respectively (p < 0.001, mean difference 26; 95% CI 21-34). No stem fractures were noted within the follow-up period.
Positive early clinical and radiological outcomes have been observed with this tapered, fluted, titanium, monobloc stem. Based on these results, this implant may be considered as a viable option in the majority of uncemented femoral revisions.
设计了一种新的带三锥度的有槽钛制一体式股骨柄，试图克服在广泛骨丢失情况下进行股骨重建所面临的挑战。本研究旨在报告其早期临床和影像学结果。
这是一项在 2017 年 1 月至 2019 年 12 月期间在一家单机构进行的前瞻性数据回顾性研究。43 例股骨翻修采用新型锥形、有槽、钛制、一体式（TFTM）翻修柄。并发症、临床和影像学数据来自病历和本地维护的数据库。使用牛津髋关节评分（OHS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评估临床结果。所有术后 X 线片均分析有无下沉、骨溶解和股骨皮质骨重塑。
平均随访 24 个月（8-42 个月）。1 例患者出现 1.2mm 的下沉。未观察到有临床意义的下沉（>10mm）。末次随访时，功能结局评分有显著改善。术前 OHS 均值为 24（SD13），末次随访时为 42（SD15）。p=0.04 差值 18（95%CI 15-22）。术前 WOMAC 均值为 62（SD23），末次随访时为 88（SD7）（p<0.001，差值 26；95%CI 21-34）。随访期间未发现股骨柄骨折。
该锥形、有槽、钛制一体式股骨柄具有良好的早期临床和影像学结果。基于这些结果，该植入物可能被视为大多数非骨水泥股骨翻修的可行选择。
