NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.
Department of Orthopaedic Surgery, Zucker School of Medicine at Hofstra/Northwell, Huntington Hospital, Huntington, NY.
J Arthroplasty. 2022 Jul;37(7S):S577-S581. doi: 10.1016/j.arth.2022.03.020. Epub 2022 Mar 11.
Although increased femoral head size reduces the risk of instability in total hip arthroplasty (THA), it may lead to iliopsoas irritation and increased anterior groin pain. The purpose of this study is to compare outcomes between non-modular dual-mobility (NDM) implants and small (≤32 mm) and large (≥36 mm) fixed-bearing (FB) constructs.
A retrospective review of all primary total hip arthroplasties from 2011 to 2021 was conducted at a single, urban academic institution. Patients were separated into 3 cohorts: NDM implant ≤32 mm and FB implant ≥36 mm. Demographics and outcomes such as length of stay, dislocation, and anterior groin pain were assessed. Patients were deemed as having groin pain if they received an iliopsoas injection or had extended physical therapy ordered beyond 3 months postoperatively.
There were 178 NDM implants, 936 ≤32-mm FB, and 2,454 ≥36-mm FB implants included. Length of stay significantly differed between the groups (48.4 ± 43.3 vs 63.2 ± 40.6 vs 57.2 ± 38.1 hours; P = .001). Although not statistically significant, the ≥36-mm FB cohort had the highest rate of dislocations (0.6% vs 0.7% vs 0.9%; P = .84). Although no patients with an NDM implant received an iliopsoas injection, 9 patients (0.9%) with a ≤32-mm FB implant and 9 patients (0.4%) with a ≥36-mm implant received an injection (P = .06). However, 18 (10.1%) patients with an NDM implant, 304 (32.5%) patients with a ≤32-mm FB implant, and 355 (14.5%) patients with a ≥36-mm FB implant received extended physical therapy 3 months after surgery (P < .001).
NDM implants, as well as FB implants with both small and large head sizes are effective at preventing dislocation. NDM implants did not result in an increase in anterior groin pain compared to ≤32-mm and ≥36-mm FB constructs.
Retrospective cohort study.
虽然增大股骨头尺寸可降低全髋关节置换术（THA）中不稳定的风险，但可能导致髂腰肌激惹和增加前腹股沟疼痛。本研究的目的是比较非模块式双动（NDM）植入物与小（≤32mm）和大（≥36mm）固定轴承（FB）结构的结果。
对单所城市学术机构 2011 年至 2021 年所有初次全髋关节置换术进行回顾性分析。患者分为 3 组：NDM 植入物≤32mm 和 FB 植入物≥36mm。评估了患者的人口统计学和结果，如住院时间、脱位和前腹股沟疼痛。如果患者接受了髂腰肌注射或术后 3 个月以上接受了延长物理治疗，则认为他们有腹股沟疼痛。
共纳入 178 例 NDM 植入物、936 例≤32mm FB 植入物和 2454 例≥36mm FB 植入物。各组的住院时间差异有统计学意义（48.4±43.3、63.2±40.6、57.2±38.1 小时；P=0.001）。尽管无统计学意义，但≥36mm FB 组的脱位率最高（0.6%、0.7%、0.9%；P=0.84）。虽然没有接受 NDM 植入物的患者接受了髂腰肌注射，但有 9 例（0.9%）接受≤32mm FB 植入物的患者和 9 例（0.4%）接受≥36mm 植入物的患者接受了注射（P=0.06）。然而，有 18 例（10.1%）接受 NDM 植入物的患者、304 例（32.5%）接受≤32mm FB 植入物的患者和 355 例（14.5%）接受≥36mm FB 植入物的患者在术后 3 个月接受了延长物理治疗（P<0.001）。
NDM 植入物以及小、大头尺寸的 FB 植入物均能有效预防脱位。与≤32mm 和≥36mm FB 结构相比，NDM 植入物不会增加前腹股沟疼痛。
证据等级 III：回顾性队列研究。
