Department for Joint Replacement, Rheumatoid and General Orthopaedics, Orthopaedic Clinic Markgröningen, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Germany.
Orthopaedic Department, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
BMC Musculoskelet Disord. 2022 Mar 5;23(1):212. doi: 10.1186/s12891-022-05152-9.
The reconstruction of the individual anatomy is important in total hip replacement. The aim of the study was to compare two different kinds of stems with respect to the reconstruction of the individual anatomy of the hip.
We compared the restoration of the anatomical parameters (horizontal and vertical offset, femoral neck-shaft angle (NSA) and leg length) of 100 unilateral CoreHip (CH) implantations with 100 unilateral implantations of a standard anatomical stem (Exception (E)). The CoreHip has three different NSAs and exhibits a constant femoral neck length for the different sizes. The Exception stem has a standard and lateralized version with two different NSAs and, in both versions, the femoral neck length increases proportionately with size. The anatomical parameters of the operated and healthy sides were measured and the differences between the two stems compared.
The horizontal (2.5 ± 2.8 mm (mean ± SD) for CH vs. 5.4 ± 4.1 mm for E, p < 0.001) and vertical offset (4.1 ± 3.5 mm for CH vs. 5.0 ± 3.8 mm, p = 0.024) and femoral neck-shaft-angle (1.7 ± 1.6 degrees for CH vs. 5.6 ± 3.4 degrees for E, p < 0.001) could be reconstructed significantly better with the CoreHip system. There was a tendency for the leg length (4.0 ± 3.9 mm for CH vs. 4.5 ± 3.8 mm; p = 0.11) to be better restored with the CoreHip.
The reconstruction of the individual anatomy of the hip with an endoprosthesis could be realized significantly better with the stem that was designed with three different femoral neck-shaft angles and a constant femoral neck length over different sizes.
在全髋关节置换术中，重建个体解剖结构非常重要。本研究旨在比较两种不同类型的假体柄在重建髋关节个体解剖结构方面的差异。
我们比较了 100 例单侧 CoreHip（CH）植入物和 100 例单侧标准解剖型假体柄（Exception（E））植入物的解剖参数（水平和垂直偏移、股骨颈干角（NSA）和下肢长度）的恢复情况。CoreHip 有三种不同的 NSA，并且对于不同的尺寸，其股骨颈长度保持不变。Exception 假体柄有标准和侧置两种版本，两种版本的股骨颈长度都随尺寸成比例增加。测量了手术侧和健侧的解剖参数，并比较了两种假体柄之间的差异。
CH 的水平（2.5±2.8mm）和垂直偏移（4.1±3.5mm）以及股骨颈干角（1.7±1.6 度）的重建明显优于 E（分别为 5.4±4.1mm、5.0±3.8mm 和 5.6±3.4 度，p<0.001）。下肢长度（CH 为 4.0±3.9mm，E 为 4.5±3.8mm，p=0.11）的恢复也有更好的趋势。
与设计有三种不同股骨颈干角和不同尺寸股骨颈长度不变的假体柄相比，使用假体柄可以更好地重建髋关节的个体解剖结构。
