4세대 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절 전치환술: 최소 2년 이상 추시 결과
Cementless Total Hip Arthroplasty with Fourth Generation Ceramic-on-Ceramic Articulation: Minimum Two Years of Follow-up
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목적: 4세대 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절 전치환술 후 2년 이상 단기 추시 관찰한 임상적, 방사선학적 결과를 보고하고자 한다. 대상 및 방법: 2009년 4월부터 12월까지 본원 정형외과에서 4세대 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절치환술을 시행한 환자 25명, 26예 중 2년 이상 추시가 가능했던 22명, 23예를 대상으로 하였다. 환자의 평균 연령은 55.9세(22-72세)였으며, 추시 관찰기간은 평균 28개월(24-32개월)이었다. 임상적 평가는 Harris hip score (HHS)에 근거하였으며, 방사선학적 평가는 비구컵과 대퇴 삽입물 주변의 골 용해, 불안정성, 고정위치 및 이동 등을 관찰하였다. 결과: HHS는 술 전 평균 54점에서 최종 추시시 91점으로 향상되었으며, 서혜부 동통 1예, 대퇴부 동통 2예가 관찰되었다. 방사선학적 평가는 전 예에서 골내 안정을 얻었고, 비구컵과 대퇴 삽입물의 이동, 위치 변형, 골 용해 소견은 관찰되지 않았다. 결론: 4세대 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절전치환술의 단기 추시 결과는 임상적 및 방사선학적으로 만족할 만한 결과를 보였다. 앞으로 더 많은 수의 환자를 대상으로 장단점 및 합병증의 발생여부에 대해 장기간의 추시가 필요할 것이다.
Abstract
Purpose: The purpose of this study is to report clinical and radiographic results over a period of two 2 years after cementless total hip arthroplasty (THA) with fourth generation ceramic-on-ceramic articulation. Materials and Methods: We studied 22 patients, 23 cases which were followed up for two years among 25 patients, 26 patients who underwent cementless THA with the fourth generation ceramic between April 2009and December 2009. The average age of the patients was 55.9 years old(22 to 72 years old), and the average follow-up duration was 28 months(24 to 32 months). A clinical evaluation was performed using the Harris hip score (HHS), and radiologic evaluation was based on acetabular cups and osteolysis of the femoral stems, instability, distance, angle, and so on. Results: HHS showed an increase, from 54 for before-surgical treatment, to 91 at the last follow-up. Inguinal pain was observed in one case, and femoral pain was observed in two cases. Stable fixation was achieved in all cases, and no instability, osteolysis, or movement of acetabular cups and femoral stems was observed. Conclusion: Clinical and radiological short-term results for use ofthe fourth generation ceramic-on-ceramic cementless THA have favorable so far. Further follow-up study should be performed for evaluation of the longterm results.
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