무시멘트 근위조함 원위고정형 스템을 이용한 인공고관절 재치환술

Abstract

Purpose: We report the short-term results of a cementless proximal modular distal fixation femoral stem used in revision total hip arthroplasty(THA). Materials & Methods: Thirty-four patients who underwent a THA using a Link MP or Lima revision femoral stem between April 1998 and September 2001 were followed for at least 2 years and 6 months. The mean age of the patients was 55 years(range, 37~75 months) and the mean follow-up period was 38 months(range,31~73 months ). The preoperative diagnoses included 25 cases of aseptic loosening, 3 cases of septic loosening, 4 cases of recurrent dislocation and 2 cases of periprosthetic fracture associated with loosening. The clinical results were analyzed using the Harris hip score, postoperative thigh pain, limping and the radiological outcomes from a plain radiograph taken 6 weeks, 3 and 6 month and 1 year, postoperatively and then yearly thereafter. R e s u l t s: The mean Harris Hip score improved from 34.6 points(range,23~56) preoperatively to 88.1 points (range,73~96) postoperatively. Thigh pain was evident in 3 cases (8.8%) and a limping gait on gait analysis was present in 7 cases(20.9%). The femoral stem showed a subsidence of < 2 mm in 29 cases (85.2%) and the average canal filling index of the femoral stem was 88.7%(range, 75.4~96.9%). Complications included 5 cases of intraoperative femoral cracks, 4 cases of a post-operative hip dislocation, and 1 case of a periprosthetic fracture. C o n c l u s i o n: Satisfactory short-term results were obtained from using a cementless proximal modular distal fixation femoral stem in revision total hip arthroplasty, which allows an easier distal fixation and a correction of the femoral anteversion and stem length.