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股骨柄对线对全髋关节置换术中假体周围骨密度的影响:一项关于Avenir Complete柄的研究。

Impact of femoral stem alignment on periprosthetic bone density in THA: a study of the Avenir Complete stem.

作者信息

Maeda Takuma, Kuroda Yuichi, Kamenaga Tomoyuki, Matsumoto Tomoyuki, Kuroda Ryosuke, Hayashi Shinya

机构信息

Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

出版信息

Arch Orthop Trauma Surg. 2024 Dec 21;145(1):74. doi: 10.1007/s00402-024-05617-7.

Abstract

INTRODUCTION

Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD.

MATERIALS AND METHODS

Consecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included. Dual-energy X-ray absorptiometry was used to assess BMD changes, and computed tomography scans were used to evaluate stem alignment.

RESULTS

BMD was maintained in the distal femur, but showed a slight decrease in the proximal femur. A negative correlation was observed among varus malalignment, anteversion errors, and changes in BMD in the proximal femur.

CONCLUSIONS

The findings underscore the importance of accurate stem positioning in THA, particularly in avoiding varus malalignment and anteversion errors, as misalignment can adversely affect proximal femoral BMD and potentially lead to early stem loosening. This study enhances the understanding of the influence of the Avenir Complete stem on postoperative BMD, highlighting the need for precise alignment to optimize outcomes.

摘要

引言

全髋关节置换术后出现大腿疼痛、无菌性松动及失败的情况已有报道。因此,本研究使用Avenir Complete非骨水泥型股骨柄,探讨股骨柄对线对全髋关节置换术(THA)假体周围骨密度(BMD)的影响,重点关注精确的股骨柄对线在维持股骨近端骨密度方面的作用。

材料与方法

纳入2019年3月至2022年3月期间通过仰卧位微创前外侧入路接受Avenir Complete股骨柄的连续患者。采用双能X线吸收法评估骨密度变化,使用计算机断层扫描评估股骨柄对线情况。

结果

股骨远端骨密度得以维持,但股骨近端骨密度略有下降。股骨近端内翻畸形、前倾角误差与骨密度变化之间存在负相关。

结论

研究结果强调了全髋关节置换术中精确股骨柄定位的重要性,尤其是避免内翻畸形和前倾角误差,因为对线不良会对股骨近端骨密度产生不利影响,并可能导致早期股骨柄松动。本研究加深了对Avenir Complete股骨柄对术后骨密度影响的理解,突出了精确对线以优化手术效果的必要性。

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