Hunter Michael, Fawley David W, Diaz Rodrigo, Barrett William, Croker Sean, Gorab Robert
Orthopedics, Hoag Orthopedic Institute, Irvine, USA.
Clinical Research, DePuy Synthes, Warsaw, USA.
Cureus. 2024 May 1;16(5):e59462. doi: 10.7759/cureus.59462. eCollection 2024 May.
Background The anterior approach for total hip arthroplasty (THA) has gained popularity in recent years. Some surgeons have been hesitant to adopt the approach due to concerns over increased complications such as intraoperative fracture, stem loosening, and stem revision. This study aims to evaluate the all-cause revision rate and survivorship of a collared, triple-tapered stem that was designed specifically for use with the anterior approach in THA to enhance outcomes and reduce adverse events. Methodology A retrospective outcomes review was conducted to assess survivorship and clinical outcomes for a specific proximally coated, medially collared triple-tapered (MCTT) femoral stem. Results In a cohort of 5,264 hips, Kaplan-Meier survivorship estimates (95% confidence interval [CI]; with further follow-up), with survivorship defined as no revision of any component for any reason at five years after the index procedure, were 98.9% (97.8%-99.4%; 43) under the clinical assumption and 99.6% (99.4%-99.7%; 894) under the registry assumption. With survivorship defined as stem revision for any reason, survivorship estimates at five years postoperatively were 99.6% (99.3%-99.8%; 43) under the clinical assumption and 99.8% (99.7%-99.9%; 894) under the registry assumption. The mean follow-up time was 94.52 days (standard deviation [SD] 2.24, range 90.03-96.02). At five years postoperatively, the mean Harris Hip Score was 95.19, and the mean Hip Disability and Osteoarthritis Outcome Score Junior (HOOS JR) score was 98.66. Conclusions Our evaluation demonstrates excellent construct and stem survivorship and very low complication rates at midterm postoperative follow-up.
背景 近年来,全髋关节置换术(THA)的前路手术越来越受欢迎。一些外科医生因担心术中骨折、柄松动和柄翻修等并发症增加而对采用该手术方法犹豫不决。本研究旨在评估一种专门为THA前路手术设计的带颈三锥度柄的全因翻修率和生存率,以提高手术效果并减少不良事件。方法 进行了一项回顾性结果评估,以评估一种特定的近端涂层、内侧带颈三锥度(MCTT)股骨干的生存率和临床结果。结果 在5264例髋关节队列中,Kaplan-Meier生存率估计值(95%置信区间[CI];进一步随访),生存率定义为初次手术后五年内无任何原因的任何组件翻修,临床假设下为98.9%(97.8%-99.4%;43),登记假设下为99.6%(99.4%-99.7%;894)。生存率定义为因任何原因进行柄翻修时,术后五年的生存率估计值临床假设下为99.6%(99.3%-99.8%;43),登记假设下为99.8%(99.7%-99.9%;894)。平均随访时间为94.52天(标准差[SD]2.24,范围90.03-96.02)。术后五年,平均Harris髋关节评分95.19,平均髋关节残疾和骨关节炎结果评分青少年版(HOOS JR)为98.66。结论 我们的评估表明,在术后中期随访中,该结构和柄的生存率极佳,并发症发生率极低。