Result of Modular Necks in Primary Total Hip Arthroplasty with a Average Follow-up of Four Years
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Purpose: This study aimed to investigate the outcomes of modular neck-utilization in primary total hip arthroplasty (THA). Materials and Methods: Thirty patients (34 hips) who had modular stem THA between April 2011 and January 2013 were evaluated. There were 19 men and 11 women with a mean age of 61.2 years at the time of surgery. There were 20 cases of osteonecrosis of femoral head, 7 cases of osteoarthritis, 6 cases of femur neck fracture, and 1 case of rheumatoid arthritis. No patients presented with anatomical deformity of hip. Patients were operated on using a modified Watson-Jones anterolateral approach. All patients underwent clinical and radiological follow-up at 6 weeks, 3, 6, and 12 months, and every year postoperatively. The mean duration of follow-up was 48.2 months (range, 39 to 59 months). Results: The average Harris hip score improved from 63.7 to 88.1 at the final follow-up. Radiographically, mean acetabular cup inclination was 45.3。(range, 36。-61。) and anteversion was 21.7。(range, 11。-29。). All were neutral-positioned stems except 5 which were varus-positioned stems. In only 3 cases (8.8%), varus or valgus necks were required. A case of linear femoral fracture occurred intraoperatively and 1 case of dislocation occurred at postoperative 2 weeks. No complications at modular junction were occurred. Conclusion: Our study shows that the use of modular necks had favorable clinical and radiographic results. This suggests that the use of modular neck in primary THA without anatomical deformity is safe at a follow-up of 39 months.
Abstract
Purpose: This study aimed to investigate the outcomes of modular neck-utilization in primary total hip arthroplasty (THA). Materials and Methods: Thirty patients (34 hips) who had modular stem THA between April 2011 and January 2013 were evaluated. There were 19 men and 11 women with a mean age of 61.2 years at the time of surgery. There were 20 cases of osteonecrosis of femoral head, 7 cases of osteoarthritis, 6 cases of femur neck fracture, and 1 case of rheumatoid arthritis. No patients presented with anatomical deformity of hip. Patients were operated on using a modified Watson-Jones anterolateral approach. All patients underwent clinical and radiological follow-up at 6 weeks, 3, 6, and 12 months, and every year postoperatively. The mean duration of follow-up was 48.2 months (range, 39 to 59 months). Results: The average Harris hip score improved from 63.7 to 88.1 at the final follow-up. Radiographically, mean acetabular cup inclination was 45.3。(range, 36。-61。) and anteversion was 21.7。(range, 11。-29。). All were neutral-positioned stems except 5 which were varus-positioned stems. In only 3 cases (8.8%), varus or valgus necks were required. A case of linear femoral fracture occurred intraoperatively and 1 case of dislocation occurred at postoperative 2 weeks. No complications at modular junction were occurred. Conclusion: Our study shows that the use of modular necks had favorable clinical and radiographic results. This suggests that the use of modular neck in primary THA without anatomical deformity is safe at a follow-up of 39 months.
참고문헌 (29)
- Toni A, "Cementless hip arthroplasty with a modular neck", Chir Organi Mov, 86, pp.73~85 (2001)
- Dunbar MJ, "The proximal modular neck in THA : a bridge too far : affirms", Orthopedics, 33, pp.640~ (2010)
- Gill IP, "Corrosion at the neck-stem junction as a cause of metal ion release and pseudotumour formation", J Bone Joint Surg Br, 94, pp.895~900 (2012)
- Murugappan KS, "Outcome after modular neck hip arthroplasty: lessons from the registry", J Bone Joint Surg Br, 94-B, pp.112~ (2012)
- Harris WH, "Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation", J Bone Joint Surg Am, 51, pp.737~755 (1969)
- Gruen TA, ""Modes of failure"of cemented stem-type femoral components : a radiographic analysis of loosening", Clin Orthop Relat Res, 141, pp.17~27 (1979)
- Engh CA, "Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components", Clin Orthop Relat Res, 257, pp.107~128 (1990)
- Woo RY, "Dislocations after total hip arthroplasty", J Bone Joint Surg Am, 64, pp.1295~1306 (1982)
- Berry DJ, "The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty", J Bone Joint Surg Am, 86-A, pp.9~14 (2004)
- Collier JP, "The tradeoffs associated with modular hip prostheses", Clin Orthop Relat Res, 311, pp.91~101 (1995)
- Atwood SA, "Corrosion-induced fracture of a double-modular hip prosthesis : a case report", J Bone Joint Surg Am, 92, pp.1522~1525 (2010)
- Garbuz DS, "The John Charnley Award : Metal-on-metal hip resurfacing versus large-diameter head metal-on-metal total hip arthroplasty : a randomized clinical trial", Clin Orthop Relat Res, 468, pp.318~325 (2010)
- Sporer SM, "A case of disassociation of a modular femoral neck trunion after total hip arthroplasty", J Arthroplasty, 21, pp.918~921 (2006)
- Sotereanos NG, "Modular femoral neck fracture after primary total hip arthroplasty", J Arthroplasty, 28, pp.196~ (2013)
- Ellman MB, "Fracture of the modular femoral neck component in total hip arthroplasty", J Arthroplasty, 28, pp.196~ (2013)
- Skendzel JG, "Total hip arthroplasty modular neck failure", J Arthroplasty, 26, pp.338~ (2011)
- Wilson DA, "Early failure of a modular femoral neck total hip arthroplasty component : a case report", J Bone Joint Surg Am, 92, pp.1514~1517 (2010)
- Dangles CJ, "Failure of the modular neck in a total hip arthroplasty", J Arthroplasty, 25, pp.1169~ (2010)
- Jacobs JJ, "Metal release in patients who have had a primary total hip arthroplasty. A prospective, controlled, longitudinal study", J Bone Joint Surg Am, 80, pp.1447~1458 (1998)
- Willert HG, "Metal-onmetal bearings and hypersensitivity in patients with artificial hip joints. A clinical and histomorphological study", J Bone Joint Surg Am, 87, pp.28~36 (2005)
- Kop AM, "Proximal component modularity in THA--at what cost? An implant retrieval study", Clin Orthop Relat Res, 470, pp.1885~1894 (2012)
- Imbuldeniya AM, "The S-ROM hydroxyapatite proximally-coated modular femoral stem in revision hip replacement: results of 397hips at a minimum ten-year follow-up", Bone Joint J, 96-B, pp.730~736 (2014)
- Tanzer M, "Primary cementless total hip arthroplasty using a modular femoral component:a minimum 6-year follow-up", J Arthroplasty, 16(8Suppl 1), pp.64~70 (2001)
- Ollivier M, "Titanium-titanium modular neck for primary THA. Result of a prospective series of 170 cemented THA with a minimum follow-up of 5 years", Orthop Traumatol Surg Res, 101, pp.137~142 (2015)
- De Martino I, "Corrosion and fretting of a modular hip system : a retrieval analysis of 60 rejuvenate stems", J Arthroplasty, 30, pp.1470~1475 (2015)
- Lanting BA, "Correlation of corrosion and biomechanics in the retrieval of a single modular neck total hip arthroplasty design : modular neck total hip arthroplasty system", J Arthroplasty, 30, pp.135~140 (2015)
- Archibeck MJ, "A comparison of two implant systems in restoration of hip geometry in arthroplasty", Clin Orthop Relat Res, 469, pp.443~446 (2011)
- Sariali E, "Accuracy of reconstruction of the hip using computerised three-dimensional pre-operative planning and a cementless modular neck", J Bone Joint Surg Br, 91, pp.333~340 (2009)
- Gerhardt DM, "Modular necks in primary hip arthroplasty without anatomical deformity: no clear benefit on restoration of hip geometry and dislocation rate. An exploratory study", J Arthroplasty, 29, pp.1553~1558 (2014)