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髋关节置换术中短柄与常规柄股骨柄的中期临床和影像学结果比较。

Comparison of mid-term clinical and radiological results of short and conventional femoral stems in total hip arthroplasty.

机构信息

Orthopedics and Traumatology Department, Ankara City Hospital, Ankara, Turkey.

Orthopedics and Traumatology Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Sci Rep. 2024 Aug 5;14(1):18060. doi: 10.1038/s41598-024-68696-x.

Abstract

This study aims to answer the question: Which are superior-conventional or short femoral stems?. An Optymis stem was used as a short-femoral stem, and an Accolade II stem was used as a conventional-femoral stem. There were 95 patients in the short femoral stem group (Group 1) and 90 in the conventional stem group (Group 2). The SF-36 Life Quality Score, thigh pain, and the Harris Hip Score were used to evaluate the patients' clinical outcomes. Pre-operative, immediate post-operative, and final follow-up x-rays were used for radiological evaluation. Stem varus/valgus alignment, hip offset changing, acetabular anteversion/inclination changing, femoral migration, acetabular migration, periarticular ossification, and osteointegration evaluation were assessed for both groups. The mean follow-up time was 5.5 years for Group 1 and 5.2 years for Group 2. No significant difference existed between the two groups in terms of clinical scores (Harris Hip Score, SF-36). Thigh pain was significantly higher in Group 2 (p = 0.0001). As for radiological parameters, Group 1 exhibited more varus position-related results. In terms of angular stability, Group 1 was found to be more unstable than Group 2 (p = 0.0001). The power to reconstruct femoral offset was superior in Group 1. Periarticular ossification was more frequent in Group 2. Femoral osteointegration was denser proximally in Group 1 and distally in Group 2. When mid-term radiological and clinical results of both femoral stems are evaluated, they have no superiority over each other.

摘要

本研究旨在回答以下问题

传统股骨柄与短柄相比,哪种更优越?使用 Optymis 短柄作为短柄组,Accolade II 股骨柄作为传统股骨柄。短柄组 95 例(组 1),传统柄组 90 例(组 2)。采用 SF-36 生活质量评分、大腿疼痛和 Harris 髋关节评分评估患者的临床疗效。采用术前、术后即刻和最终随访 X 线片进行影像学评估。评估两组患者的股骨柄内翻/外翻、髋关节中心外移变化、髋臼前倾角/倾斜度变化、股骨迁移、髋臼迁移、关节周围骨化和骨整合情况。组 1 的平均随访时间为 5.5 年,组 2 为 5.2 年。两组临床评分(Harris 髋关节评分、SF-36)无统计学差异。组 2 的大腿疼痛明显高于组 1(p=0.0001)。在影像学参数方面,组 1 表现出更多的内翻位置相关结果。在角度稳定性方面,组 1 比组 2更不稳定(p=0.0001)。组 1 重建股骨偏心距的能力更强。组 2 关节周围骨化更常见。组 1 股骨近端骨整合更密集,组 2 股骨远端骨整合更密集。当评估两种股骨柄的中期影像学和临床结果时,它们彼此之间没有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1ca/11300442/3cb0cf0eda86/41598_2024_68696_Fig1_HTML.jpg

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