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现代手术中 Metha 短柄全髋关节置换术的未来。

Future of total hip arthroplasty with the Metha short stem in modern surgeries.

机构信息

Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, ul. Pomorska 251, 92-213, Lodz, Poland.

Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland.

出版信息

Sci Rep. 2021 Nov 5;11(1):21763. doi: 10.1038/s41598-021-01367-3.

Abstract

The aim of the study was to analyse the results of uncemented total hip replacement, using the Metha (metaphyseal) stem. A total of 158 patients (70 females and 88 males) were qualified to the study and submitted to total hip arthroplasty (183 procedures altogether), using the Metha stem. The mean age of the patients on the day of surgery was 51.7 years (the range from 17 to 69 years). The mean follow up period was 9.2 years (the range from 5 to 13.5 years). Preoperative assessments gave poor scores, according to the Merle d'Aubigne and Postel classification, modified by Charnley. The average improvement after surgery, according to the used scale, was 6.9 points. A very good outcome was recorded in 154 cases (84.2%), a good outcome was achieved in 20 cases (10.9%) and a poor outcome was confirmed in 9 cases, while no satisfactory case was observed. Poor outcomes were associated with implant loosening. Extraskeletal ossification was noted in 10 cases (5.5%). According to the Kaplan-Meier estimator, the 10-year survival was 93.2% and 97.3% for the whole implant and the stem alone, respectively. 1. Our follow-up period of more than 9 years on the average, indicates that Metha stems produce excellent clinical and functional results in operated young patients with advanced degenerative changes of the hip joint. 2. Assuming a proper qualification for the procedure, the absence of complications and a correct surgical technique, which is slightly more difficult, when compared to standard stem implantation, the risk of aseptic loosening is fairly negligible.

摘要

本研究旨在分析使用 Metha(干骺端)股骨柄的非骨水泥全髋关节置换的结果。共有 158 名患者(70 名女性和 88 名男性)符合研究条件,并接受了全髋关节置换术(总共 183 例),使用 Metha 股骨柄。手术当天患者的平均年龄为 51.7 岁(年龄范围为 17 岁至 69 岁)。平均随访时间为 9.2 年(范围为 5 年至 13.5 年)。根据 Merle d'Aubigne 和 Postel 分类,经 Charnley 改良后的评分,术前评估得分较差。根据使用的量表,手术后的平均改善程度为 6.9 分。154 例(84.2%)获得非常好的结果,20 例(10.9%)获得良好的结果,9 例(5.5%)确认结果较差,没有观察到满意的结果。较差的结果与植入物松动有关。10 例(5.5%)出现了关节外骨化。根据 Kaplan-Meier 估计器,全植入物和单独股骨柄的 10 年生存率分别为 93.2%和 97.3%。1. 我们的平均随访时间超过 9 年,表明 Metha 股骨柄在接受手术的年轻患者中,对于髋关节晚期退行性改变具有出色的临床和功能效果。2. 假设手术程序适当、无并发症且手术技术正确(与标准股骨柄植入相比,技术难度略高),无菌性松动的风险可忽略不计。

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