금속 대 금속 관절면을 이용한 고관절 표면 치환술-최소 3년 추시 결과-
Minimum 3 years Follow-up Results of Metal on Metal HipResurfacing Arthroplasty
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목적: 금속 대 금속 관절면을 이용한 고관절 표면 치환술의 최소 3년 추시결과를 보고 하고자 하였다. 대상 및 방법: 2001년 10월부터 2004년 4월까지 금속 대 금속 관절면을 이용한 고관절 표면 치환술을 시행받고 최소 3년 이 상 추시가 가능하였던 20예의 환자를 대상으로 하였다. 평균 연령은 49세(25~67세) 였으며 평균 추시 기간은 56개월(36~84 개월) 이었다. 임상적 결과는 Harris 고관절 점수를 이용하여 평가하였으며, 방사선학적 결과는 술 후 정기적으로 촬영한 사진 들을 분석하였으며 표면 치환술과 관련된 합병증을 조사하였다. 결과: 임상적으로 Harris 고관절 점수는 수술 전 평균 46점에서 최종 추시시 평균 94점으로 향상되었다. 방사선 사진상 비구컵 의 해리소견은 보이지 않았으며 대퇴 스템의 삽입각도는 대퇴골 간부에 대하여 평균 135도 였으며 최종 추시시 내반 및 외반 변형은 보이지 않았다. 그 외 삽입물 주위의 골용해 소견을 보인 예가 없었으며 최소 3년 추시상 대퇴 경부 골절 및 감염, 부품 의 해리, 탈구 등은 관찰되지 않았다. 결론: 고관절 표면 치환술은 단기 추시 결과 우수한 생존율 및 기존의 고관절 전치환술에 비해 우수한 생존율을 보였으며 향후 더 많은 증례와 장기 추시가 필요할 것으로 사료된다.
Abstract
Purpose: To present the survival of consecutive patients with a minimum of three years follow-up after undergoing a metal-on-metal hip resurfacing arthroplasty. Materials and Methods: Twenty hips from twenty patients (male: 16, female: 4) who underwent metal-on-metal resurfacing arthroplasty between October 2001 and April 2004 were followed up for at least 3 years. The mean patient age was 49 years (range 23~70), and the mean follow-up period was 56 months (range 36~84 months). A clinical evaluation was performed using the Harris hip score, and radiologic evaluation was performed regularly after surgery with plain radiographs. Results: The mean Harris hip score improved from 46 points (range 73~32) preoperatively to 94 points at final follow-up. There were no cases of radiolucency or osteolysis around the stem or acetabular cup, and there was no migration of the acetabular or femoral component. The average femoral stem-shaft angle was 135ခ(range 121ခ- 139ခ), and at the final follow-up study, there was no change of the femoral stem. Conclusion: In the short-term, metal-on-metal resurfacing arthroplasty performed on the basis of bone quality and patient selection, showed excellent clinical and radiological results. Hip resurfacing is an attractive option for young patients fearing a potentially difficult future revision or for more active patients with hip disease.
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