Ralles Steven, Murphy Michael P, Farooq Hassan, Grayson Whisper, Hopkinson William J, Brown Nicholas M
Loyola University Health System, Department of Orthopaedic Surgery and Rehabilitation, Maywood, IL 60153, USA.
J Orthop. 2024 Aug 3;59:27-29. doi: 10.1016/j.jor.2024.08.001. eCollection 2025 Jan.
Using larger femoral heads during total hip arthroplasty (THA) may result in a more stable hip. Greater volumetric wear and frictional torque, however, may result in increased postoperative complications. The purpose of this study was to compare outcomes of patients with femoral head size ≥40 mm compared to those with femoral head size <40 mm.
A retrospective chart review of 504 THAs performed by a single surgeon at a single institution from 2009 to 2016 was conducted. Following exclusions, 131 THAs were identified with femoral heads ≥40 mm and 348 THAs were identified with femoral heads <40 mm. In addition to demographic data, all postoperative complications were recorded. Plain radiographs were used to rule out/in periprosthetic osteolysis and/or acetabular loosening. Chi-square tests and Student's t-tests were used to compare categorical and continuous variables, respectively.
Mean follow-up period for the entire cohort was 5.5 years. Complications with ≥40 mm femoral heads included 1 superficial infection and 1 deep periprosthetic joint infection (PJI). There were no cases of dislocation, osteolysis, acetabular loosening, or trunnionosis. In contrast, complications with <40 mm femoral heads included 9 dislocations and 7 PJIs.
The routine use of large femoral heads (≥40-mm) during THA appears to be a safe option for patients at short-term clinical follow-up. Notably, 0 patients had a clinical course complicated by dislocation, osteolysis, acetabular loosening, or trunnionosis.
Level III Retrospective Cohort Study.
在全髋关节置换术（THA）中使用更大的股骨头可能会使髋关节更稳定。然而，更大的体积磨损和摩擦扭矩可能会导致术后并发症增加。本研究的目的是比较股骨头尺寸≥40mm的患者与股骨头尺寸<40mm的患者的治疗结果。
对2009年至2016年在单一机构由单一外科医生实施的504例全髋关节置换术进行回顾性病历审查。排除相关病例后，确定131例股骨头≥40mm的全髋关节置换术和348例股骨头<40mm的全髋关节置换术。除人口统计学数据外，记录所有术后并发症。使用X线平片排除/诊断假体周围骨溶解和/或髋臼松动。分别使用卡方检验和学生t检验比较分类变量和连续变量。
整个队列的平均随访期为5.5年。股骨头≥40mm的并发症包括1例表浅感染和1例深部假体周围关节感染（PJI）。没有脱位、骨溶解、髋臼松动或柄部腐蚀的病例。相比之下，股骨头<40mm的并发症包括9例脱位和7例PJI。
在短期临床随访中，全髋关节置换术期间常规使用大尺寸股骨头（≥40mm）对患者似乎是一种安全的选择。值得注意的是，没有患者出现因脱位、骨溶解、髋臼松动或柄部腐蚀而导致的临床病程复杂情况。
III级回顾性队列研究。
