Scott David F, Eppich Kade, Mehić Edin, Gray Celeste, Smith Crystal Lederhos, Johnston Michael
Elson S. Floyd College of Medicine at Washington State University, 412 E Spokane Falls, Blvd, Spokane, WA, 99202, USA.
Spokane Joint Replacement Center, Inc., Spokane, WA, USA.
BMC Musculoskelet Disord. 2024 Apr 22;25(1):312. doi: 10.1186/s12891-024-07422-0.
Hip offset, version, and length are interdependent femoral variables which determine stability and leg length. Balancing these competing variables remains a core challenge in hip arthroplasty. The potential benefits of modular femoral stems have been overshadowed by higher rates of failure. The objective of this study was to assess the survivorship of a unique dual-modular femoral stem at an average 15-year follow-up period.
The records of all patients with osteoarthritis who underwent primary total hip arthroplasty with this device between 2004-2009 were reviewed. There were no exclusions for BMI or other factors. We examined the data with Kaplan-Meier survival analysis. The primary endpoint for survival was mechanical failure of the modular neck-body junction.
The survivorship of this device in 172 subjects was 100% with none experiencing mechanical failure of the modular junction at an average of 15 years. 60 patients died of causes unrelated to their THA and 9 patients were lost to follow-up. There were three early (≤ 12 months) dislocations (1.7%), and seven total dislocations (4.1%). 16 patients underwent reoperations during the follow-up period, none for any complication of the modular junction. Radiographic results showed well-fixed femoral stems in all cases. There were no leg length discrepancies of greater than 10 mm, and 85% were within 5 mm.
There were no mechanical failures of the modular junction in any of the subjects over the average 15-year period, demonstrating that this dual-modular design is not associated with increased failure rates. We achieved a 1.7% early dislocation rate and a 4.1% total dislocation rate without any clinically significant leg length discrepancies.
髋臼偏移、股骨颈前倾角和股骨长度是相互关联的股骨变量，决定着髋关节的稳定性和下肢长度。平衡这些相互矛盾的变量仍然是髋关节置换术中的核心挑战。模块化股骨柄的潜在优势已被更高的失败率所掩盖。本研究的目的是评估一种独特的双模块化股骨柄在平均15年随访期内的生存率。
回顾了2004年至2009年间所有使用该装置进行初次全髋关节置换术的骨关节炎患者的记录。对体重指数或其他因素不做排除。我们采用Kaplan-Meier生存分析来检查数据。生存的主要终点是模块化颈体连接处的机械故障。
该装置在172名受试者中的生存率为100%，平均15年时无一人出现模块化连接处的机械故障。60名患者死于与全髋关节置换术无关的原因，9名患者失访。有3例早期（≤12个月）脱位（1.7%），7例总脱位（4.1%）。16名患者在随访期间接受了再次手术，均非因模块化连接处的任何并发症。影像学结果显示所有病例的股骨柄固定良好。下肢长度差异均未超过10毫米，85%在5毫米以内。
在平均15年的时间里，所有受试者的模块化连接处均未出现机械故障，表明这种双模块化设计与失败率增加无关。我们实现了1.7%的早期脱位率和4.1%的总脱位率，且下肢长度差异均无临床显著性。
