López R E, Pelayo de Tomás J M, Morales Suárez Varela M, Rodrigo Pérez J L
Hospital Universitario Doctor Peset, Valencia, Spain.
Hospital Universitario Doctor Peset, Valencia, Spain; Facultad de Medicina, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain.
Rev Esp Cir Ortop Traumatol. 2022 Nov-Dec;66(6):T27-T35. doi: 10.1016/j.recot.2022.07.015. Epub 2022 Jul 17.
Dual modularity stems seek to more precisely restore anatomy by allowing intraoperative adjustments thanks to modular necks. Our aim is to compare the radiographic length correction with the H MAX-M® Stem versus its monoblock counterpart H MAX-S®.
A prospective cohort study was carried out through consecutive sampling on patients who underwent primary total hip arthroplasty with coxarthrosis diagnosis between 2011 and 2015. One arm of the cohort included patients who were operated with a modular stem and the other with a monobloc stem. Length was measured on the anteroposterior pelvic-bearing radiograph at 6 months. 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 correction of asymmetry between both groups, determined as the difference in length between the operated hip and the contralateral hip (p=.106). Nor were differences observed in postoperative length values (p=.053). It should be noted that for both the modular stem and the monobloc stem, the majority group is the one with restored length (84.1% and 80.4%, respectively; p=.001).
Despite the theoretical advantage of modularity and that having interchangeable parts could be of great interest, in our study, we have not been able to demonstrate a superiority of modular designs compared to monoblock for control of postoperative leg length discrepancy.
双模块化柄旨在通过模块化颈部实现术中调整,从而更精确地恢复解剖结构。我们的目的是比较H MAX - M®柄与一体式对应物H MAX - S®柄在影像学上的长度矫正效果。
通过连续抽样对2011年至2015年间诊断为髋关节骨性关节炎并接受初次全髋关节置换术的患者进行前瞻性队列研究。队列的一组包括接受模块化柄手术的患者,另一组包括接受一体式柄手术的患者。在术后6个月的骨盆正位X线片上测量长度。比较队列中每组获得的测量平均值。
两组之间在不对称矫正方面未观察到统计学上的显著差异,不对称矫正定义为手术侧髋关节与对侧髋关节之间的长度差异(p = 0.106)。术后长度值也未观察到差异(p = 0.053)。应当指出的是,对于模块化柄和一体式柄,大多数患者组的长度都得到了恢复(分别为84.1%和80.4%;p = 0.001)。
尽管模块化在理论上具有优势,且其可互换部件可能非常有意义,但在我们的研究中,我们未能证明模块化设计在控制术后下肢长度差异方面优于一体式设计。