Wanner Ronald, Butler Ransohoff Christopher, Wyss Tobias, Nötzli Hubert
Department of Orthopaedics, Emmental Hospital, 3400 Burgdorf, Switzerland.
Department of Orthopaedics and Trauma Surgery, Inselspital, 3010 Bern, Switzerland.
J Clin Med. 2024 Sep 20;13(18):5570. doi: 10.3390/jcm13185570.
Hip arthroplasty is a common elective surgery worldwide, with rising numbers due to demographic changes and an emphasis on maintaining physical activity in the elderly. The development of new implant designs, especially shorter uncemented stems, has contributed to the advancement of minimally invasive implantation techniques. However, the long-term in vivo behaviour of these implants, particularly regarding subsidence, stability, and stress shielding, remains to be fully understood. This retrospective, monocentric cohort study analyses the long-term radiographic outcomes of the first 141 patients who underwent total hip arthroplasty with the Fitmore Hip Stem between June 2007 and December 2008. It focuses on subsidence, stability, varus-valgus alignment, and the influence of patient-related, anatomical, and surgical factors on implant behaviour over a 10-year follow-up period. The average change in varus/valgus alignment was 0.7° into varus and the average subsidence was 1.7 mm over 10 years, with most changes occurring within the first six weeks postoperatively. The varus-valgus alignment and subsidence did not significantly change after the first year, indicating stable osteointegration of the implant. Neither patient factors (gender, age) nor surgical and implant factors (implantation angle, approach, stem family, size, total offset) had a significant influence on the long-term behaviour of the implant. The Fitmore Hip Stem shows highly reliable long-term stability and integration, unaffected by various patient, surgical, and implant factors, as confirmed by excellent register data. Nevertheless, monitoring of this and other new implants should be continued in order to determine implant behaviour, possible weaknesses, and indication limits at an early stage for the benefit of the patient.
髋关节置换术是全球常见的择期手术,由于人口结构变化以及对老年人保持身体活动的重视,其手术数量不断增加。新型植入物设计的发展,特别是更短的非骨水泥型股骨柄,推动了微创植入技术的进步。然而,这些植入物的长期体内行为,尤其是关于下沉、稳定性和应力遮挡方面,仍有待充分了解。这项回顾性单中心队列研究分析了2007年6月至2008年12月期间接受Fitmore髋关节股骨柄全髋关节置换术的前141例患者的长期影像学结果。研究重点关注下沉、稳定性、内翻-外翻对线,以及在10年随访期内患者相关、解剖学和手术因素对植入物行为的影响。10年内,内翻/外翻对线的平均变化为内翻0.7°,平均下沉为1.7毫米,大多数变化发生在术后六周内。术后第一年之后,内翻-外翻对线和下沉没有显著变化,表明植入物的骨整合稳定。患者因素(性别、年龄)以及手术和植入物因素(植入角度、入路、股骨柄系列、尺寸、总偏移)均对植入物的长期行为没有显著影响。如出色的登记数据所证实,Fitmore髋关节股骨柄显示出高度可靠的长期稳定性和整合性,不受各种患者、手术和植入物因素的影响。尽管如此,仍应继续监测这种及其他新型植入物,以便尽早确定植入物行为、可能存在的弱点和适应证限制,从而造福患者。