Thuan Mai Duc, Dung Nguyen Quoc
Department of Joint Surgery Institute of Trauma and Orthopedic - 108 Military Central Hospital, Hanoi, Vietnam.
Adv Orthop. 2024 Jul 9;2024:4623071. doi: 10.1155/2024/4623071. eCollection 2024.
Total hip arthroplasty with traditional stem joints, although bringing many benefits to patients indicated for hip replacement, faces many difficulties in reoperations in young patients due to the limited lifespan of the artificial joint. Recently, the short-stem joint was introduced to help overcome this problem. This study aims to evaluate the results of short-stem implants for primary total hip arthroplasty in Vietnamese adults.
The study design is retrospective longitudinal. The study subjects were 91 patients with aseptic necrosis of the femoral head who underwent short-shaft cementless total hip replacement surgery from February 2012 to December 2018. Outcomes that were assessed included implant survivorship, Harris hip scores, thigh pain, periprosthetic fracture, subsidence, proximal stress shielding, the prevalence of stem malalignment, and inappropriate implant sizing.
Our research group has 119 hips of 91 patients (28 patients had hip replacements on both sides), with the average follow-up time of 67.1 months. Seven cases of early joint loosening required replacing the traditional stem. The survival rate is 94.1%. The average Harris hip score 24 months after surgery was statistically significantly higher than before (92.00 ± 4.47 and 45.56 ± 3.22, respectively, < 0.001). The average leg length discrepancy between the two limbs before surgery was 9.5 ±mm and 24 months after surgery was 3.4 ± 2.9 mm. There were 12 cases (10.1%) of partial bone loss around the femoral stem; 12 cases of joint displacement of more than 2 mm, accounting for 10.1%; and 1 case of acetabular fracture, accounting for 0.8%.
The Spiron short stem has certain advantages suitable for young patients, restoring the hip anatomy and significantly improving postoperative hip function. However, this is a complex technique that needs to be performed by experienced surgeons who have practiced for a long time. We encourage using the short-stem implant during primary total hip arthroplasty in Vietnamese adult patients.
采用传统柄部关节的全髋关节置换术，虽然给适合髋关节置换的患者带来了诸多益处，但由于人工关节使用寿命有限，在年轻患者再次手术时面临诸多困难。近年来，短柄关节应运而生以帮助解决这一问题。本研究旨在评估越南成年人初次全髋关节置换术中短柄植入物的效果。
本研究设计为回顾性纵向研究。研究对象为91例股骨头无菌性坏死患者，他们于2012年2月至2018年12月接受了无骨水泥短柄全髋关节置换手术。评估的结果包括植入物生存率、Harris髋关节评分、大腿疼痛、假体周围骨折、下沉、近端应力遮挡、柄部排列不齐的发生率以及植入物尺寸不当情况。
我们的研究组有91例患者的119个髋关节（28例患者双侧进行了髋关节置换），平均随访时间为67.1个月。7例早期关节松动需要更换传统柄部。生存率为94.1%。术后24个月的平均Harris髋关节评分在统计学上显著高于术前（分别为92.00±4.47和4
