López R E, Gómez Aparicio S, Pelayo de Tomás J M, Morales Suárez Varela M, Rodrigo Pérez J L
Hospital Universitario Doctor Peset, Valencia, España; Hospital Lluís Alcanys, Xàtiva, Valencia, España.
Hospital Universitario Doctor Peset, Valencia, España.
Rev Esp Cir Ortop Traumatol. 2022 Mar-Apr;66(2):77-85. doi: 10.1016/j.recot.2021.08.003. Epub 2021 Nov 27.
Dual modularity stems were introduced with the theoretical advantage of restoring hip anatomy more precisely through femoral offset and limb length adjustment. Interchangeable necks allow for intraoperative angulation, anteversion and length changes. Our objective is to study whether a better femoral offset correction is achieved with the H MAX-M® prosthesis (Limacorporate, San Daniele, Italy) compared to its monoblock counterpart.
A prospective cohort study was conducted by means of consecutive sampling on adult patients undergoing total hip arthroplasty with the diagnosis of coxarthrosis between January 2011 and December 2015. This cohort has two arms, one arm included patients who underwent modular neck arthroplasty and the other included patients who underwent monoblock total hip arthroplasty. Radiographic offset measurement of the operated hip and the contralateral hip was performed, and the difference between both values was calculated. The mean of the measurements obtained for each arm of the cohort were compared with each other.
No statistically significant differences were observed in the difference in offset between the operated hip and the contralateral hip (P=.323). No statistically significant differences were observed in the correction of the femoral offset, determined as the difference between the operated hip and the contralateral hip (P=.323). Nor were differences observed in the postoperative offset values (P=.097). It should be noted that for both designs, the majority group is the one with restored offset (P=.001).
双模块化柄被引入,其理论优势在于通过股骨偏心距和肢体长度调整更精确地恢复髋关节解剖结构。可互换的颈干角允许术中进行角度、前倾角和长度的改变。我们的目的是研究与整体式假体相比,H MAX-M® 假体(意大利圣丹尼尔的Limacorporate公司)是否能实现更好的股骨偏心距矫正。
对2011年1月至2015年12月期间因髋关节骨关节炎诊断而接受全髋关节置换术的成年患者进行连续抽样,开展一项前瞻性队列研究。该队列分为两组,一组包括接受模块化颈干角置换术的患者,另一组包括接受整体式全髋关节置换术的患者。对手术侧髋关节和对侧髋关节进行影像学偏心距测量,并计算两者数值的差值。比较队列中每组获得测量值的均值。
手术侧髋关节与对侧髋关节偏心距差值无统计学显著差异(P = 0.323)。以手术侧髋关节与对侧髋关节差值确定的股骨偏心距矫正无统计学显著差异(P = 0.323)。术后偏心距值也无差异(P = 0.097)。应当指出,对于两种设计,大多数患者的偏心距得以恢复(P = 0.001)。