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矩形弯短柄假体薄与厚多孔涂层在非骨水泥全髋关节置换中的放射学变化比较：一项倾向性评分匹配的回顾性研究。

Comparison of radiographic changes in rectangular curved short stem with thin versus thick porous coating for cementless total hip arthroplasty: a retrospective study with a propensity score matching.

机构信息

Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

出版信息

J Orthop Surg Res. 2021 Apr 13;16(1):247. doi: 10.1186/s13018-021-02397-3.

DOI:10.1186/s13018-021-02397-3
PMID:33849591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8042942/
Abstract

BACKGROUND

Radiographic changes that appear relatively quickly after fixation of cementless stem in total hip arthroplasty (THA) vary depending on the stem design and fixation style. The present study compared radiographic changes between two types of rectangular curved short stems of similar shape.

METHODS

This retrospective study included 118 hips that underwent primary cementless THA with an anterolateral supine approach using a rectangular, curved, short stem performed by the same surgeon between June 2015 and June 2019. Among the examined hips, 39 had a thicker porous coating stem (thicker group) and 66 had a thinner porous coating and reduced tip stem (thinner group) and at least 12-month follow-up. Radiographs taken during the final course observation were assessed. Propensity score matching was performed based on demographic data and comparisons were made using pairs of 25 hips each. Statistical analysis was performed using chi-square test and p values ≤ 0.05 indicated statistical significance.

RESULTS

The pattern of the radiolucent lines showed a significant difference after matching (p = 0.0044). A "proximal and distal" pattern was most common in the thicker group and a "distal only" pattern was most common in the thinner group. There was notable and significant difference in cortical hypertrophy in the thicker group after matching (p = 0.024).

CONCLUSIONS

Although the two short stems were similar shapes, the short-term radiographic changes were different. The thinner group showed fewer radiographic changes than the thicker group, making it a more "silent" stem.

摘要

背景

非骨水泥假体固定后即刻出现的影像学改变因假体设计和固定方式而异。本研究比较了两种类似形状的矩形弯短柄的影像学变化。

方法

本回顾性研究纳入了 2015 年 6 月至 2019 年 6 月间由同一位医生采用前外侧仰卧入路行初次非骨水泥全髋关节置换术的 118 髋。在研究的髋关节中，39 髋使用了厚多孔涂层柄（厚组），66 髋使用了薄多孔涂层和减小尖端的柄（薄组），且均至少随访 12 个月。评估了最后一次随访时的 X 线片。根据人口统计学数据进行倾向评分匹配，比较每组 25 髋。采用卡方检验进行统计学分析，p 值≤0.05 表示具有统计学意义。

结果

匹配后透亮线的模式存在显著差异（p=0.0044）。厚组中“近段和远段”模式最常见，薄组中“仅远段”模式最常见。匹配后厚组的皮质骨肥大有明显且显著的差异（p=0.024）。

结论

尽管两种短柄形状相似，但短期影像学变化不同。薄组的影像学变化较厚组少，是一种更“安静”的假体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/7acb3e61279a/13018_2021_2397_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/2ec86a0a7679/13018_2021_2397_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/c7874c3e01ee/13018_2021_2397_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/4ede892feeb1/13018_2021_2397_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/07831dd0d465/13018_2021_2397_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/9f3ace4730c7/13018_2021_2397_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/d990157657b9/13018_2021_2397_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/7acb3e61279a/13018_2021_2397_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/2ec86a0a7679/13018_2021_2397_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/c7874c3e01ee/13018_2021_2397_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/4ede892feeb1/13018_2021_2397_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/07831dd0d465/13018_2021_2397_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/9f3ace4730c7/13018_2021_2397_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/d990157657b9/13018_2021_2397_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffed/8042942/7acb3e61279a/13018_2021_2397_Fig7_HTML.jpg

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