全髋关节置换术后 Corail 柄下沉：与骨接触无关。

Subsidence of the Corail stem in total hip arthroplasty: no influence of bony contact.

机构信息

Department of Orthopaedic, Trauma, and Reconstructive Surgery, University Hospital Aachen, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany.

Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano, 39100, Bolzano, Italy.

出版信息

J Orthop Traumatol. 2024 Nov 10;25(1):53. doi: 10.1186/s10195-024-00794-y.

DOI:10.1186/s10195-024-00794-y

PMID:39522073

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11551085/

Abstract

INTRODUCTION

This study investigated stem subsidence following primary total hip arthroplasty (THA) with a Corail stem in patients who underwent two-staged bilateral THA. The second outcome of interest was to investigate whether a specific single cortical bone contact point might reduce postoperative stem subsidence.

METHODS

The present study was conducted following the STROBE guidelines. The records of patients who underwent THA between 2016 and 2023 were accessed. All patients who underwent two-staged bilateral THA were retrieved. The direct contact between the stem and the cortical bone was assessed at various points in the metaphysis and the distal portion of the stem (diaphysis) in both anteroposterior radiographs of the pelvis (medial and lateral bone contact) and a Lauenstein view of the hip (anterior and posterior bone contact). The following parameters were measured and compared to assess stem subsidence: distance from the proximal femur at the stem bone interface and the tip of the lesser trochanter (distance A); distance from the tip of the lesser trochanter and the tip of the femoral stem (distance B).

RESULTS

In total, 250 patients were included, 45% (149 of 250 patients) were women and 61% (153 of 250 THAs) were implanted primarily on the right side. The mean age of patients at the time of the first THA was 64.3 ± 10.0 years and the mean body mass index (BMI) was 28.0 ± 4.9 kg/m. The mean length of the follow-up was 14.1 ± 10.8 months. The overall stem subsidence following THA was 2.8 ± 0.7 mm (P < 0.006). A direct cortical bone-implant contact did not exert a statistically significant difference in subsidence of the THA stem at the metaphysis and diaphysis (P > 0.5). Stem subsidence following THA with a collarless cementless Corail stem was approximately 2.8 mm at 14 months.

CONCLUSIONS

Direct cortical bone contact of the stem at diaphysis and metaphysis seems not to influence stem subsidence following THA using the Corail stem.

摘要

介绍

本研究调查了在接受两阶段双侧全髋关节置换术（THA）的患者中，使用 Corail 柄行初次全髋关节置换术后的柄沉降情况。第二项研究结果为：是否特定的单一皮质骨接触点可能减少术后柄沉降。

方法

本研究遵循 STROBE 指南进行。查阅了 2016 年至 2023 年接受 THA 的患者记录。检索了所有接受两阶段双侧 THA 的患者。在骨盆前后位 X 线片（内侧和外侧骨接触）和髋关节 Lauenstein 位片（前侧和后侧骨接触）中评估柄在骨干和干骺端的直接皮质骨接触情况。测量并比较以下参数以评估柄沉降：距柄骨界面近端股骨和小转子尖端的距离（A 距离）；小转子尖端和股骨柄尖端的距离（B 距离）。

结果

共纳入 250 例患者，其中 45%（250 例患者中的 149 例）为女性，61%（250 例 THA 中的 153 例）首次植入在右侧。首次 THA 时患者的平均年龄为 64.3±10.0 岁，平均体重指数（BMI）为 28.0±4.9 kg/m。平均随访时间为 14.1±10.8 个月。THA 后总体柄沉降为 2.8±0.7mm（P<0.006）。皮质骨-植入物直接接触在骨干和干骺端的 THA 柄沉降方面没有统计学上的显著差异（P>0.5）。使用无领非骨水泥 Corail 柄行 THA 后，柄沉降约为 14 个月时的 2.8mm。