인공 고관절 전치환술에서 Combined Anteversion 확보를 위한 조립형 대퇴스템의 유용성
Usefulness of a Modular Hip System for Combined Anteversion in Cementless Total Hip Arthroplasty
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목적: 조립형 무시멘트 인공 고관절 전치환술에 있어 combined anteversion의 확보를 위한 조립형 대퇴스템의 유용성을 알아보고자 한다. 대상 및 방법: 20예의 환자를 대상으로 비구컵과 대퇴 주대를 삽입하고, 대퇴 골두 밑면과 비구컵의 변연부가 평행면을 이루는 방법(manual combined anteversion test)을 통해 modular neck을 선택하였다. 수술 후 CT를 통해 비구컵의 전염각과 대퇴 주대의 전염각을 측정하고 통합 전염각을 산출하였다. 결과: 측정된 비구컵의 전염각은 평균 15.9±2.9。, 대퇴 주대의 전염각은 15.2±11.9。, 산출된 통합 전염각은 24.0±8.2。이었다. 통합 전염각은 이상적인 범위(37-42。)에 비하여 통계학적으로 유의하게 작았으며(P<0.0001) 비구컵의 전염각 또한 이상적인 범위 20-28。와 비교하여 통계적으로 유의하게 작았다(P<0.0001). 결론: 조립형 무시멘트 인공고관절 전치환술에서 manual combined anteversion test와 modular neck을 선택하는 방법은 이상적인 combined anteversion를 획득하지 못하였다.
Abstract
Purpose: The purpose of this study is to evaluate the usefulness of a modular total hip system for combined anteversion in cementless modular total hip arthroplasty. Materials and Methods: We performed twenty cementless modular total hip arthroplasty procedures. The patients lay in lateral position and 15。internal rotation of the thigh. The surgeon inserted an acetabular cup component first, followed by a femoral component. He selected an appropriate modular neck component using an intra-operative manual combined anteversion test. All patients underwent post-operative computed tomography. Results: The average measurement of anteversion of the acetabular cup was 15.9±2.9。and anteversion of the femoral stem was 15.2±11.9。. Then, the combined anteversion was calculated to 24.0±8.2。. Significant difference was observed between combined anteversion and theoretical combined anteversion. Conclusion: The method using an intra-operative manual combined anteversion test cannot realize the theoretical combined anteversion in cementless modular hip arthroplasty
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