Kato Daisaku, Takegami Yasuhiko, Seki Taisuke, Osawa Yusuke, Takemoto Genta, Okamoto Masanori, Iida Hiroki, Imagama Shiro
Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, 466-8550, Japan.
J Orthop. 2022 Nov 4;35:58-63. doi: 10.1016/j.jor.2022.10.014. eCollection 2023 Jan.
Total hip arthroplasty (THA) for hip disorders helps to alleviate pain and improve active daily life. When determining the effects of medical therapy and the subsequent clinical results, patient quality of life (QOL) also needs to be assessed. Recently, patient-reported outcomes (PRO) have become important as evaluation criteria. This study aimed to evaluate patient QOL and various PRO between different types of cementless stems and to clarify the relationship between PRO and stem-cortical bone contact.
The study comprised 138 consecutive patients undergoing cementless THA for hip osteoarthritis. We assessed three different types of PRO: the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), patient's joint perception, and peri-hip articular joint pain (PHAP). We measured the state of contact between femur and implant by density mapping.
No significant difference was noted in PRO between stem types based on the JHEQ and patient's joint perception. PHAP occurred more frequently in the patients with a taper wedge stem versus a fit-and-fill stem. In both groups, distal contact was associated with PHAP but not with JHEQ results and patient's joint perception.
The difference in PHAP between the two stem types groups was significant, with postoperative PHAP being higher with the taper wedge stem because of the more distal contact between the taper wedge stem and femur cortical bone.
全髋关节置换术（THA）用于治疗髋关节疾病，有助于减轻疼痛并改善日常生活活动能力。在确定药物治疗效果及后续临床结果时，还需要评估患者的生活质量（QOL）。近年来，患者报告结局（PRO）已成为重要的评估标准。本研究旨在评估不同类型非骨水泥柄之间患者的生活质量及各种患者报告结局，并阐明患者报告结局与柄-皮质骨接触之间的关系。
本研究纳入了138例因髋关节骨关节炎连续接受非骨水泥全髋关节置换术的患者。我们评估了三种不同类型的患者报告结局：日本骨科协会髋关节疾病评估问卷（JHEQ）、患者的关节感知以及髋关节周围关节疼痛（PHAP）。我们通过密度映射测量股骨与植入物之间的接触状态。
基于JHEQ和患者的关节感知，不同柄类型之间的患者报告结局无显著差异。与适配填充柄相比，锥形楔形柄患者中PHAP的发生频率更高。在两组中，远端接触与PHAP相关，但与JHEQ结果和患者的关节感知无关。
两种柄类型组之间的PHAP差异显著，由于锥形楔形柄与股骨皮质骨之间的远端接触更多，术后锥形楔形柄患者的PHAP更高。
