Shah Imran, Khan Zeeshan, Khan Zainab Aqeel, Ekram Ali, Butt Umer, Shah Junaid Ali
Orthopaedic and Trauma Surgeon, AO Hospital, Karachi, Pakistan.
Orthopaedic Surgeon, Rehman Medical Institute, Peshawar and AO Hospital, Karachi, Pakistan.
J Clin Orthop Trauma. 2024 Nov 26;59:102843. doi: 10.1016/j.jcot.2024.102843. eCollection 2024 Dec.
The tapered fluted titanium stem is a viable option for complex hip reconstruction. We therefore, evaluate the results of complex hip arthroplasty for femoral bone loss (Paprosky type IIIA to type IV femoral defect), using a modular fluted titanium stem.
Data for this retrospective study was collected from the medical records of the 2 participating orthopaedic units from December 2018 to December 2021. Twenty-seven patients who underwent reconstruction of femoral bone loss with a modular fluted titanium stem were included in this study. General, demographic and clinical data including patient's age, comorbidities, ambulatory status before and after surgery, blood transfusion, surgical complications, rehabilitation after surgery, length of stay in hospital (in days), readmission after surgery, implant details and mortality rate were recorded. Clinical evaluation was performed using the oxford hip score and 12-item short-form health survey (SF-12). Complications and survivorship were evaluated using Kaplan-Meier survival rate with 95 % confidence interval.
The mean age for the cohort was 60.14 ± 11.58 years, with mean follow-up of 3.2 years for the study. The median pre-operative OHS was 10 (8), which improved to 39 (12) and 41 (4) at 1 and 2-year postoperative follow-up, respectively (P < 0. 001). The quality of life measures (SF-12 scores) in both mental and physical components showed progressive improvement at 2 years follow-up with P- value < 0.001. A total of five patients (18.5 %) had postoperative complications, including deep venous thrombosis in one patient, dislocations in two patients and one patient each with superficial and deep infection. The implant survival rate was 100 % at mean follow-up of 3.2 years.
Proximal femur reconstruction with a modular fluted titanium stem restores mobility, improves the quality of life and reduces pain significantly. It can be considered as a good option as a salvage procedure.
锥形带槽钛柄是复杂髋关节重建的一种可行选择。因此，我们使用模块化带槽钛柄评估复杂髋关节置换术治疗股骨骨丢失（帕罗夫斯基III A型至IV型股骨缺损）的结果。
本回顾性研究的数据收集自2018年12月至2021年12月参与研究的两个骨科单位的医疗记录。本研究纳入了27例行模块化带槽钛柄重建股骨骨丢失的患者。记录患者的一般情况、人口统计学和临床数据，包括患者年龄、合并症、手术前后的活动状态、输血情况、手术并发症、术后康复、住院天数、术后再次入院情况、植入物细节和死亡率。使用牛津髋关节评分和12项简短健康调查问卷（SF - 12）进行临床评估。使用Kaplan - Meier生存率及95%置信区间评估并发症和生存率。
该队列的平均年龄为60.14±11.58岁，研究的平均随访时间为3.2年。术前牛津髋关节评分中位数为10（8），术后1年和2年随访时分别提高到39（12）和41（4）（P < 0.001）。在2年随访时，精神和身体成分的生活质量指标（SF - 12评分）均显示出逐步改善，P值< 0.001。共有5例患者（18.5%）出现术后并发症，包括1例深静脉血栓形成、2例脱位，以及各1例浅表和深部感染。在平均3.2年的随访中，植入物生存率为100%。
使用模块化带槽钛柄进行股骨近端重建可恢复活动能力，提高生活质量并显著减轻疼痛。它可被视为一种良好的挽救手术选择。
