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双侧非骨水泥全髋关节置换中的组件不对称。

Component Asymmetry in Bilateral Cementless Total Hip Arthroplasty.

机构信息

Department of Orthopaedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea.

出版信息

Clin Orthop Surg. 2023 Feb;15(1):27-36. doi: 10.4055/cios22028. Epub 2022 Aug 9.

Abstract

BACKGROUND

This study investigated the results of component asymmetry (CA) in bilateral cementless total hip arthroplasty (THA).

METHODS

This study included 300 patients, who underwent bilateral cementless THA between April 2000 and December 2017. They were divided into the component symmetry (CS) and CA groups; CA group was sub-classified into acetabular component asymmetry (ACA) and femoral component asymmetry (FCA). Radiologic and clinical outcomes of the CA group were compared with those of the CS group.

RESULTS

The incidence of CA was 25.7% (77/300 patients), including 55 patients with ACA, 34 patients with FCA, and 12 with both components asymmetric. The mean time interval between operations in the CA group was significantly longer than that in the CS group ( < 0.001). The mean differences in horizontal and vertical distances from teardrop to the center of rotation of the acetabular component between both hips in the ACA group were significantly larger than those in the CS group ( = 0.033 and < 0.001, respectively). The mean femoral component alignment angle difference between both hips was significantly larger in the FCA group than in the CS group ( < 0.001). The mean Harris Hip Score at last follow-up of the CA group was similar to that of the CS group.

CONCLUSIONS

CA in patients undergoing bilateral cementless THA was not rare, especially with a longer time interval between operations. Regardless of CA, when stable fixation of the components was achieved, satisfactory radiologic and clinical outcomes were obtained.

摘要

背景

本研究探讨了双侧非骨水泥全髋关节置换术(THA)中组件不对称(CA)的结果。

方法

本研究纳入了 300 例于 2000 年 4 月至 2017 年 12 月期间接受双侧非骨水泥 THA 的患者。他们被分为组件对称(CS)和 CA 组;CA 组进一步分为髋臼组件不对称(ACA)和股骨组件不对称(FCA)。比较了 CA 组与 CS 组的影像学和临床结果。

结果

CA 的发生率为 25.7%(77/300 例患者),包括 55 例 ACA、34 例 FCA 和 12 例双组件不对称。CA 组的平均手术时间间隔明显长于 CS 组( < 0.001)。ACA 组中双侧髋臼组件旋转中心到泪滴的水平和垂直距离的平均差值明显大于 CS 组( = 0.033 和 < 0.001)。FCA 组中双侧股骨组件对线角度的平均差值明显大于 CS 组( < 0.001)。CA 组的最后随访时的平均 Harris 髋关节评分与 CS 组相似。

结论

在接受双侧非骨水泥 THA 的患者中,CA 并不罕见,尤其是手术时间间隔较长时。无论是否存在 CA,只要组件获得稳定固定,都能获得满意的影像学和临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/caaf/9880502/25711eb61943/cios-15-27-g001.jpg

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