Fujii Hideki, Hayama Tetsuo, Abe Toshiomi, Takahashi Motoi, Amagami Ayano, Matsushita Yohei, Otani Takuya, Saito Mitsuru
Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Bone Jt Open. 2022 Jan;3(1):20-28. doi: 10.1302/2633-1462.31.BJO-2021-0122.R1.
Although the short stem concept in hip arthroplasty procedure shows acceptable clinical performance, we sometimes get unexplainable radiological findings. The aim of this retrospective study was to evaluate changes of radiological findings up to three years postoperatively, and to assess any potential contributing factors on such radiological change in a Japanese population.
This is a retrospective radiological study conducted in Japan. Radiological assessment was done in accordance with predetermined radiological review protocol. A total of 241 hips were included in the study and 118 hips (49.0%) revealed radiological change from immediately after surgery to one year postoperatively; these 118 hips were eligible for further analyses. Each investigator screened whether either radiolucent lines (RLLs), cortical hypertrophy (CH), or atrophy (AT) appeared or not on the one-year radiograph. Further, three-year radiographs of eligible cases were reviewed to determine changes such as, disappeared (D), improved (I), stable (S), and progression (P). Additionally, bone condensation (BC) was assessed on the three-year radiograph.
CH was observed in 49 hips (21.1%), AT was observed in 63 hips (27.2%), and RLLs were observed in 34 hips (14.7%) at one year postoperatively. Among 34 hips with RLLs, 70.6% showed change of either D or I on the three-year radiograph. BC was observed in younger patients more frequently.
The Fitmore stem works well in a Japanese population with favourable radiological change on hips with RLLs. Longer-term follow-up is required to determine clinical relevance. Cite this article: 2022;3(1):20-28.
尽管髋关节置换术中短柄概念显示出可接受的临床效果,但我们有时会得到无法解释的影像学结果。这项回顾性研究的目的是评估术后三年的影像学结果变化,并评估日本人群中导致这种影像学变化的任何潜在因素。
这是一项在日本进行的回顾性影像学研究。影像学评估按照预定的影像学审查方案进行。该研究共纳入241例髋关节,其中118例(49.0%)在术后即刻至术后一年出现影像学变化;这118例髋关节符合进一步分析的条件。每位研究者在术后一年的X线片上筛查是否出现透亮线(RLLs)、皮质肥厚(CH)或萎缩(AT)。此外,对符合条件的病例的三年期X线片进行复查,以确定变化情况,如消失(D)、改善(I)、稳定(S)和进展(P)。另外,在三年期X线片上评估骨密度(BC)。
术后一年,49例(21.1%)观察到CH,63例(27.2%)观察到AT,34例(14.7%)观察到RLLs。在34例有RLLs的髋关节中,70.6%在三年期X线片上显示出D或I的变化。BC在年轻患者中更常见。
Fitmore柄在日本人群中效果良好,RLLs的髋关节有良好的影像学变化。需要进行长期随访以确定临床相关性。引用本文:2022;3(1):20-28。