골시멘트를 사용한 Versys-TM 대퇴 스템의 3-5년 추시결과
3 to 5 Years Results of Cemented Versys-TM Femoral Stem
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초록
저자들은 인공 고관절 치환술에서 높은 초기 실패율을 보였던 PrecoatⓇ 대퇴 스템보다 더 크고 길며, 대퇴 근위부가 rough-macrotexture로 표면처리된 Versys-TMⓇ 대퇴 스템을 이용한 환자들의 3~5년 추시 결과를 분석하였다. 대상 및 방법: 1988년 6월부터 1999년 5월까지 43고관절(41명)에 Cemented Versys-TMR 대퇴 스템을 이용한 인공고관절 전치환술 및 반치환술을 시행하였다. 이 중 술후 3년 이상 추시가 가능하였던 31예(29명)에서 임상적 결과 및방사선학적 결과를 평가하였다. 임상적 결과는 술전 및 술후의 Harris Hip Score를 측정하였고 방사선학적인 평가는Barrack등의 시멘트 등급과 Harris등의 기준에 따라 스템 주위의 해리를 측정하였다. 결과: 임상적 추시 결과로는 술전 Harris hip score는 61점에서 마지막 추시 결과 평균 93.1점(48~100점)로 향상되었으며, 술후 대퇴스템의 골시멘트의 Barrack의 cement grade는 Grade A 19예, Grade B 11예 및 Grade C2 1예 였으며, 완전 해리는 1예(3%)에서 발생하여 술 후 3년에 재치환술을 시행하였으며, 나머지 30예 중 유망 또는 가능해리의 예는 없었다. 대퇴부의 골용해를 보인 예도 없었다. 결론: 31예의 cemented Versys-TM 대퇴스템의 3~5년 추시 결과는 양호한 결과를 보였으나, 향후 장기 추시가 필요할 것으로 사료된다.
Abstract
Purpose: To evaluate the results of the Versys-TMⓇ femoral stem which has a rough-macrotextured surface in the proximal portion of the stem and is longer and larger than the PrecoatⓇ femoral stem with a proximal roughed surface, which showed a high rate of early failure. Materials and Methods: Between July 1998 and May 1999, 43 total hip arthroplasty or hemiarthroplasty procedures were preformed on 41 patients with an insertion of The Versys-TMⓇfemoral stem. Three hips(3 patients) died before a minimum of follow-up duration of three years, and 7 patients(7 hips) were lost to follow-up. Thirty-one hips(29 patients) were available for a clinical and radiographic follow-up at an average of 49 months(range: thirtythree to fifty-nine months). The average age of the patients was 51.7 years(range: twenty-two to seventy-eight years). R e s u l t s: One patient(3%) had the required revision for femoral component loosening three years after the arthroplasty. The clinical results were good or excellent in almost all the remaining patients. The initial postoperative radiographs demonstrated a grade-A cementing technique in the nineteen hips(58 percent), grade-B in the eleven hips(33 percent) and grade-C2 in one hip(3 percent). One hip, which showed an initial postoperative C2 cementing grade, was revised due to evidence of aseptic loosening. There was no hip that showed evidence of probable or possible loosening and osteolysis in the femoral side. Conclusion: In this study, the Versys-TMⓇ femoral stem showed slightly better results compared with the previous P r e c o a tⓇ femoral stem. However, a long-term follow-up study will be needed to clarify the implications of the femoral prosthesis surface finish or the design on the outcome of a Versys-TMⓇ femoral stem.
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