Hydroxyapatite 피복된 ABG I 삽입물을 이용한 무시멘트 인공 고관절 전치환술 : 최소 10년 이상 추시 결과
Cementless Total Hip Arthroplasty Using the ABG I Hydroxyapatite-coated Prosthesis : Minimum 10 Year Follow-up
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목적: ABG I 삽입물을 이용한 무시멘트 인공 고관절 전치환술 후 최소 10년 이상 추시한 결과를 알아보고자 한다. 대상 및 방법: 최소 10년 이상 추시가 가능한 121예를 대상으로 임상적, 방사선학적 결과를 분석하고, Kaplan-Meier 생존 분석을 시행하였다. 결과: 최종 추시 Harris 고관절 점수는 평균 84점이었으며, 비구컵 주위의 골용해는 53예(43.8%), 비구컵 해리는 5예(4.1%)에서 관찰되었다. 대퇴 스템 주위 골용해는 11예(9.1%), 스템 해리는 2예(1.7%)에서 관찰되었다. 폴리에틸렌 마모율은 0.23 mm/yr로 측정되었고 재수술은 모두 44예(36.3%)에서 시행되었다. 원인 질환에 따른 결과의 차이는 발견할 수 없었다. 비구컵의 원인으로 재수술을 한 경우 16년 생존율 56.3%, 대퇴 스템이 원인인 경우 16년 생존율 98.1%로 관찰되었다. 결론: ABG I 인공 고관절 삽입물을 이용한 무시멘트 인공 고관절 전치환술의 최소 10년 추시상 높은 골용해 발생과 낮은 비구컵 생존율을 보이는 등 우려스러운 결과가 확인되었다. 따라서, ABG I 인공 고관절 삽입물을 사용하였던 환자들에 대한 면밀한 추시 관찰이 필요할 것으로 사료된다.
Abstract
Purpose: The purpose of this study was to evaluate the outcomes of total hip arthroplasty (THA) with an ABG I hip prosthesis after a minimum ten-year follow up. Material and Methods: From January 1996 to March 2001, 121 hips in 104 patients, whi were followed up for a minimum of ten-years, were enrolled in this study. The clinical and radiographic outcomes were evaluated and Kaplan-Meier survival analysis was performed. Results: The mean Harris hip score at the last follow-up was 84 points. A radiolucent line around the cup, osteolysis, and cup loosening were observed in 5 hips(4.1%), 53 hips(43.8%), and 5 hips(4.1%), respectively. In the femoral side, osteolysis and stem loosening were observed in 11 hips(9.1%) and 2 hips(1.7%), respectively. The mean linear wear rate of the polyethylene liner was 0.23 mm/yr. Forty four revisions(36.3%) were performed. The outcomes were similar regardless of the cause of primary THA. The survival rate with the end point of revision due to cup loosening was 56.3%, and revision due to stem loosening was 98.1% after a 16 year follow-up. Conclusion: High polyethylene wear and the disappointing survival rate of the ABGI cup were observed after a minimum ten year follow-up. Therefore, close observation of patients who have received an ABG I prosthesis is necessary.
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