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老年患者队列中采用骨水泥固定短柄进行初次全髋关节置换术后的中期结果。

Mid-term outcomes after primary total hip arthroplasty with a cemented short stem in an elderly patient cohort.

作者信息

Marega Luca, Gnagni Pietro, Marega Carlo, Marega Filippo

机构信息

Department of Orthopedic Surgery 1, Istituto Clinico Sant'Anna, Via del Franzone, 31, 25127, Brescia, BS, Italy.

Department of Orthopedics and Trauma Surgery, Ospedale Civile Maggiore Di Borgo Trento, University of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, VR, Italy.

出版信息

Arch Orthop Trauma Surg. 2024 Dec 27;145(1):96. doi: 10.1007/s00402-024-05734-3.

Abstract

PURPOSE

The main objective of this prospective study was to assess clinical, radiographic and safety mid-term outcomes after THA with a short cemented stem in an elderly patient cohort. Moreover, the study aimed at investigating the mid-term survivorship of the implant and the incidence of complications.

METHODS

96 consecutive patients (100 cases) underwent THA with a short cemented stem. Underlying pathology was primary coxarthrosis in 93% of the cases. The clinical assessment was performed with the Harris Hip Score (HSS) and the Oxford Hip Score (OHS) and the radiographic evaluations were performed preoperatively, and at 45 days, 6, 12, 24 and 60 months postoperatively.

RESULTS

Patients' mean age at the time of surgery was of 73.4 years (range: 67.2-79.6 years). Mean HHS and OHS registered a significant improvement already 45 days after surgery, with the HHS increasing from 35.9 ± 11.3 (preoperative) to 79.2 ± 8.8 (45 days post-operatively) and the OHS increasing from 10.9 ± 4.8 (preoperative) to 34.1 ± 7.5 at 45 days (p < 0.001). Mean HHS and OHS at 5 years post operatively reached 97.2 ± 5.8 and 47.4 ± 1.4 points respectively. All implants were stable at the final follow-up with no cases of progressive radiolucent lines or osteolysis. No revisions were performed, with a survivorship of 100% at 5 years.

CONCLUSION

According to excellent clinical and patient-subjective outcomes and to the good implant stability with no component failure up to 5 years, this study suggests that the analysed short cemented stem could be a safe and performing treatment option for THA in elderly population.

LEVEL OF EVIDENCE

III.

GOV IDENTIFIER

NCT04987437.

摘要

目的

这项前瞻性研究的主要目的是评估老年患者队列中使用短柄骨水泥型股骨柄进行全髋关节置换(THA)后的临床、影像学和安全性中期结果。此外,该研究旨在调查植入物的中期生存率和并发症发生率。

方法

96例连续患者(100髋)接受了短柄骨水泥型股骨柄的THA手术。93%的病例潜在病理为原发性髋关节骨关节炎。采用Harris髋关节评分(HSS)和牛津髋关节评分(OHS)进行临床评估,并在术前、术后45天、6个月、12个月、24个月和60个月进行影像学评估。

结果

患者手术时的平均年龄为73.4岁(范围:67.2 - 79.6岁)。平均HSS和OHS在术后45天就已显著改善,HSS从术前的35.9±11.3提高到术后45天的79.2±8.8,OHS从术前的10.9±4.8提高到45天时的34.1±7.5(p < 0.001)。术后5年的平均HSS和OHS分别达到97.

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