무시멘트형 VerSys 대퇴스템을 이용한 일차적 고관절 전치환술
Primary Total Hip Arthroplasty with Cementless VerSys Femoral Stem: a Minimum 5-years follow-up
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목적: 근위부 환형 미세포말 부위에 칼시코트 제재를 도포한 VerSys Fiber Metal Midcoat 대퇴스템을 이용하여 무시 멘트형 고관절 전치환술을 시행 후 임상적 및 방사선학적 결과를 분석하였다. 대상 및 방법: 최소 5년 이상(5년~7년 6개월) 추시가 가능하였던 33명(39예)를 대상으로 하였으며, 임상적 결과는 Harris 고관절 점수를 측정하였고, 방사선학적 분석은 대퇴스템 주위의 방사선 투과선, 피질골 비후, 응력 방패에 의한 근위부 골흡수, 골용해 및 대퇴스템의 안정도와 비구컵 주위의 골용해 및 비구컵의 안정도를 분석하였다. 결과: 평균 Harris 고관절 점수는 술 전 54.2점에서 최종 추시 시 95.4점이었다. 대퇴스템 주위의 방사선 투과선 9예, 피질골 비후 1예, 응력 방패에 의한 근위부 골흡수 36예, 골용해 3예였으며 대퇴스템은 38예에서 골내성장, 1예에서 안 정된 섬유성 고정을 나타냈다. 비구컵은 38예에서 골내성장, 1예에서 불안정성 고정을 나타냈으며 골용해는 2예에서 관 찰되었다. 결론: VerSys Fiber Metal Midcoat 대퇴스템은 최소 5년 이상 추시 결과 대퇴스템 주위의 골용해 발생 빈도는 적었 으나, 응력 방패에 의한 대퇴 근위부 골흡수는 높은 빈도로 발생하여 이에 대해서는 장기간의 지속적 관찰이 필요할 것으 로 사료된다.
Abstract
Purpose: This study evaluated the clinical and radiographic results of primary total hip arthroplasty with a noncemented VerSys Fiber Metal Midcoat stem. Materials and Methods: Thirty nine hips in thirty three patients were followed up for a minimum of five years. The clinical results were evaluated based on the Harris hip scores. Radiographic analysis of the femoral component was performed by evaluating the radiolucent lines, cortical hypertrophy, stress shielding, osteolysis and fixation stability. Radiographic analysis of the acetabular component was performed by evaluating the osteolysis and fixation stability. Results: The average Harris hip score improved from 54.3 points preoperatively to 95.4 points at the last followup. In the results of radiographic analysis of the femoral component, stable bony ingrowth was noted in thirty-eight cases and stable fibrous ingrowth was observed in one. Non-progressive radiolucency < 2 mm in width was observed in eight cases. There were three cases of osteolysis, thirty-six cases of stress shielding, and one case of cortical hypertrophy. Radiographic analysis of the acetabular component revealed stable bony ingrowth in thirty-eight cases and unstable fixation in one case. There were two cases of osteolysis. Conclusion: The results of primary total hip arthroplasty using cementless VerSys femoral stem after a minimum of five-year follow up revealed that the rate of femoral osteolysis had decreased and the rate of bone resorption by stress shielding was relatively high. However, a longer-term follow up will be needed.
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