Clinical and Radiological Outcomes of Rectangular Tapered Cementless Stem According to Proximal Femoral Geometry in Elderly Asian Patients
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: A retrospective analysis of mid- to long-term clinical and radiological outcomes of Korean patients over 60 years of age who underwent hip arthroplasty using a cementless rectangular tapered stem according to Dorr proximal femur geography. Materials and Methods: From January 2007 to December 2013, 107 patients (112 hips) underwent hip arthroplasty using the C2 stem. The mean age of patients was 77.4 years (range, 60-91 years) and the mean follow-up duration was 91.1 months (range, 60-116 months). All patients were evaluated clinically and radiologically with special attention to Dorr femoral bone classification, implant fixation, radiolucent line (RLL), and thigh pain. Results: All implants demonstrated radiographic evidence of stable fixation by bone ingrowth without any change in position. The mean Harris hip score improved from 65.5±16.0 (preoperative) to 90.5±15.9 (final follow-up) (P<0.001). Incidence of RLLs, stress shielding, and thigh pain was highest in patients with Dorr type A (RLL, P=0.021; stress shielding, P=0.030; thigh pain, P<0.001). One stem revision was performed due to deep infection. The Kaplan–Meier survival rate of the femoral stem was 97.6%. Conclusion: The overall survival rate of the C2 stems was greater than 97%; there were no significant differences in survival of the C2 stem according to the Dorr classification. The incidences of RLL of thigh pain and RLL were significantly different among Dorr classifications and (highest in patients with Dorr type A).
Abstract
Purpose: A retrospective analysis of mid- to long-term clinical and radiological outcomes of Korean patients over 60 years of age who underwent hip arthroplasty using a cementless rectangular tapered stem according to Dorr proximal femur geography. Materials and Methods: From January 2007 to December 2013, 107 patients (112 hips) underwent hip arthroplasty using the C2 stem. The mean age of patients was 77.4 years (range, 60-91 years) and the mean follow-up duration was 91.1 months (range, 60-116 months). All patients were evaluated clinically and radiologically with special attention to Dorr femoral bone classification, implant fixation, radiolucent line (RLL), and thigh pain. Results: All implants demonstrated radiographic evidence of stable fixation by bone ingrowth without any change in position. The mean Harris hip score improved from 65.5±16.0 (preoperative) to 90.5±15.9 (final follow-up) (P<0.001). Incidence of RLLs, stress shielding, and thigh pain was highest in patients with Dorr type A (RLL, P=0.021; stress shielding, P=0.030; thigh pain, P<0.001). One stem revision was performed due to deep infection. The Kaplan–Meier survival rate of the femoral stem was 97.6%. Conclusion: The overall survival rate of the C2 stems was greater than 97%; there were no significant differences in survival of the C2 stem according to the Dorr classification. The incidences of RLL of thigh pain and RLL were significantly different among Dorr classifications and (highest in patients with Dorr type A).
참고문헌 (30)
- Simpson DJ, "The migration patterns of two versions of the Furlong cementless femoral stem : a randomised, controlled trial using radiostereometric analysis", J Bone Joint Surg Br, 92, pp.1356~1362 (2010)
- Kim YH, "A comparison of a conventional versus a short, anatomical metaphyseal-fitting cementless femoral stem in the treatment of patients with a fracture of the femoral neck", J Bone Joint Surg Br, 94, pp.774~781 (2012)
- Incavo SJ, "Total hip arthroplasty with the Secur-Fit and Secur-Fit plus femoral stem design a brief follow-up report at 5 to 10 years", J Arthroplasty, 23, pp.670~676 (2008)
- 이중명, "Hip Arthroplasty Using the Bencox Hip System: An Evaluation of a Consecutive Series of One Thousand Cases", Hip and Pelvis, 30(4), pp.210~218 (2018), 대한고관절학회[DOI]
- Huo MH, "Total hip arthroplasty using the Zweymuller stem implanted without cement. A prospective study of consecutive patients with minimum 3-year follow-up period", J Arthroplasty, 10, pp.793~799 (1995)
- 김정택, "Implant Design in Cementless Hip Arthroplasty", Hip and Pelvis, 28(2), pp.65~75 (2016), 대한고관절학회[DOI]
- Suckel A, "Longterm results for the uncemented Zweymuller", Alloclassic hip endoprosthesis. A 15-year minimum follow-up of 320 hip operations, 2009, pp.24, 846~853
- Korovessis P, "High medium-term survival of Zweymüller SLR-plus stem used in femoral revision", Clin Orthop Relat Res, 467, pp.2032~2040 (2009)
- Korovessis P, "High mediumterm survivorship and durability of Zweymüller-Plus total hip arthroplasty", Arch Orthop Trauma Surg, 131, pp.603~611 (2011)
- 김희중, "Cementless Total Hip Arthroplasty Using the COREN Hip System: A Minimum Five-Year Follow-up Study", Hip and Pelvis, 30(3), pp.162~167 (2018), 대한고관절학회[DOI]
- Zweymüller KA, "Radiolucent lines and osteolysis along tapered straight cementless titanium hip stems : a comparison of 6-year and 10-year followup results in 95 patients", Acta Orthop, 77, pp.871~876 (2006)
- Delaunay C, "Grit-blasted titanium femoral stem in cementless primary total hip arthroplasty : a 5-to 10-year multicenter study", J Arthroplasty, 16, pp.47~54 (2001)
- Swanson TV, "The tapered press fit total hip arthroplasty: a European alternative", J Arthroplasty, 20(4 Suppl 2), pp.63~67 (2005)
- Khanuja HS, "Cementless femoral fixation in total hip arthroplasty", J Bone Joint Surg Am, 93, pp.500~509 (2011)
- Dorr LD, "Structural and cellular assessment of bone quality of proximal femur", Bone, 14, pp.231~242 (1993)
- Dorr LD, "Comparative results of a distal modular sleeve, circumferential coating, and stiffness relief using the Anatomic Porous Replacement II", J Arthroplasty, 11, pp.419~428 (1996)
- Dorr LD, "Failure mechanisms of anatomic porous replacement I cementless total hip replacement", Clin Orthop Relat Res, (334), pp.157~167 (1997)
- Gruen TA, "“Modes of failure”of cemented stem-type femoral components: a radiographic analysis of loosening", Clin Orthop Relat Res, (141), pp.17~27 (1979)
- Engh CA, "The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty", Clin Orthop Relat Res, (231), pp.7~28 (1988)
- Grübl A, "Cementless total hip arthroplasty with the rectangular titanium Zweymuller stem. A concise follow-up, at a minimum of fifteen years, of a previous report", J Bone Joint Surg Am, 88, pp.2210~2215 (2006)
- Schmotzer H, "25 years of biologic fixation: K. Zweymüller", pp.113~118 (2007), Elsevier, Urban & Fischer
- Swanson TV, "25 years of biologic fixation: K. Zweymüller", pp.179~190 (2007), Elsevier, Urban & Fischer
- Turchetto L, "25 years of biologic fixation: K. Zweymüller", pp.107~111 (2007), Elsevier, Urban & Fischer
- 최원식, "70세 이상 고령의 대퇴 경부 골절에서의 무시멘트 양극성 고관절 반치환술", 대한정형외과학회지, 43(6), pp.703~709 (2008), 대한정형외과학회
- Park MS, "Cementless bipolar hemiarthroplasty using a rectangular cross-section stem for unstable intertrochanteric fractures", Hip Int, 23, pp.316~322 (2013)
- Vresilovic EJ, "Incidence of thigh pain after uncemented total hip arthroplasty as a function of femoral stem size", J Arthroplasty, 11, pp.304~311 (1996)
- Campbell AC, "Thigh pain after cementless hip arthroplasty. Annoyance or ill omen", J Bone Joint Surg Br, 74, pp.63~66 (1992)
- Brown TE, "Thigh pain after cementless total hip arthroplasty : evaluation and management", J Am Acad Orthop Surg, 10, pp.385~392 (2002)
- Woo J, "Population bone mineral density measurements for Chinese women and men in Hong Kong", Osteoporos Int, 12, pp.289~295 (2001)
- Walker MD, "A referent bone mineral density database for Chinese American women", Osteoporos Int, 17, pp.878~887 (2006)