Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France.
Service de Chirurgie Orthopédique et Traumatologie, CHU Amiens-Picardie, 80480, Salouël, France.
Orthop Traumatol Surg Res. 2022 Oct;108(6):103267. doi: 10.1016/j.otsr.2022.103267. Epub 2022 Mar 11.
Distal locking stems were developed in response to some complex revision procedures in total hip arthroplasty (THA), providing better axial and rotational stability. The aim of the present study was to assess medium-term clinical and radiological results of treatment with last-generation distal locking stem.
Our hypothesis was that this implant provided a high survival rate.
A single-center retrospective observational study included all patients who underwent THA revision with distal locking stem between April 2013 and January 2015 in our university hospital. The implant was a curved distal-locking stem fully coated in grit-blasted titanium alloy and hydroxyapatite (HA) with a collar made of TiAlV. This concept is based on primary distal fixation by interlocking screws. The primary endpoint was surgical revision for implant exchange.
A total of 47 procedures with distal locking stem were performed, 44 of which were included. Minimum follow-up was 5 years. Etiologies of revision comprised 25 femoral loosenings, 13 periprosthetic fractures, 3 infections, and 3 modular taper breakages. Six patients underwent re-revision (13%), with only 1 implant change (98% survival rate). Mean Harris and Oxford Hip scores at last follow-up were respectively 81±13.5 [range, 67.4-94.5] and 26±9⋅2 [range, 16.7-35.2]. Radiologically, no stem subsidence occurred, and bone ingrowth was obtained in all cases.
Fully-coated distal locking stems showed a high survival rate. They provided strong initial fixation, allowing early full weight-bearing in these frail patients.
IV; retrospective series.
为了应对全髋关节置换术（THA）中的一些复杂翻修手术，开发了带远端锁定的股骨柄，以提供更好的轴向和旋转稳定性。本研究旨在评估最后一代带远端锁定的股骨柄的中期临床和影像学结果。
我们的假设是该植入物具有高存活率。
一项单中心回顾性观察研究纳入了 2013 年 4 月至 2015 年 1 月期间在我们大学医院接受带远端锁定的股骨柄翻修的所有患者。植入物为带颈的全涂层、喷砂酸蚀钛合金和羟基磷灰石（HA）的带远端锁定的弯曲股骨柄，其颈由 TiAlV 制成。这种设计理念基于通过锁定螺钉进行的初始远端固定。主要终点是因植入物更换而进行的手术翻修。
共进行了 47 例带远端锁定的股骨柄手术，其中 44 例纳入研究。最低随访时间为 5 年。翻修的病因包括 25 例股骨松动、13 例假体周围骨折、3 例感染和 3 例模块化锥形断裂。6 例患者（13%）接受了再翻修，仅更换了 1 个植入物（存活率为 98%）。末次随访时，Harris 和 Oxford 髋关节评分分别为 81±13.5[范围，67.4-94.5]和 26±9 ⋅ 2[范围，16.7-35.2]。影像学上，未发生股骨柄下沉，所有病例均获得了骨长入。
全涂层带远端锁定的股骨柄具有较高的存活率。它们提供了强大的初始固定，使这些脆弱的患者能够早期完全负重。
IV；回顾性系列研究。
