대퇴골두 무혈성 괴사환자에서 시행된 인공 고관절 전치환술에서 두 무시멘트 스템간의 비교 분석 - Summit® 스템과 Bencox® 스템 -
Comparative Analysis of Two Cementless Stems in Total Hip Arthroplasties in Patients with Osteonecrosis of Femoral Head - Summit® Stem and Bencox® Stem -
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본 연구에서는 대퇴골두 무혈성 괴사 환자에서 Summit® 스템과 Bencox® 스템을 이용한 무시멘트 인공 고관절 전치환술 후 스템에 따른 결과를 비교 분석하고자 하였다. 대상 및 방법: 대퇴골두 무혈성 괴사로 진단받고 인공 고관절 전치환술을 시행 후 최소 3년이상 추시가 가능했던 환자를 대상으로 하였다. 환자를 스템 별로 두 군으로 나누어 Summit® 스템은 36명 44예, Bencox® 스템은 36명 48예였다. 각 군의 평균 추시기간은 78개월, 42.2개월 이었으며, 임상적 평가 및 대퇴 스템에 대한 방사선학적 평가를 시행하였다. 결과: 임상적 결과는 두군 간에 통계학적으로 유의한 차이는 없었으며, 방사선적 평가에서 골용해나 인공삽입물의 해리 소견을 보인 예는 두군 모두에서 없었다. Bencox 군의 경우 대퇴스템의 원위부위 주변에 골내막 골형성이 평균 6.4개월(3-12 개월)에서 관찰되었고, Summit 군의 경우 6예에서 원위부의 피질골 비후가 관찰 되었다. 결론: Summit 및 Bencox 스템 모두 단기 추시 결과 우수한 임상적 결과를 보였다. Bencox스템은 Summit스템에 비해 대퇴부 동통의 발생과 대퇴골 원위부 피질골 비후가 나타나지 않았으며, 이는 대퇴스템의 표면처리 방법 및 형태학적 차이에 의한 것으로 사료된다.
Abstract
We compared the clinical and radiological outcomes of total hip arthroplasty (THR) using Summit and Bencox stems. Materials and Methods: The patients who underwent cementless total hip arthroplasty were recruited with a satisfactory condition of a minimum three years of follow-ups after THR. Those patients were divided into two groups, those with Summit stems and those with Bencox stems. Summit stems were in 36 patients(40 hips), and Bencox stems in 36 patients(48 hips). Summit and Bencox stems had 78 months and 42.2 months as a mean followup, respectively. The clinical and radiological evaluations of femoral components were performed. Results: There was no difference in clinical results between the two groups. Under the radiological findings, there were no osteolytic changes or loosening. Osseointegration was detected at an average of 6.4 months(3-12 months) in the Bencox stem on the distal portion of the femoral stem, and cortical hypertrophy was detected on 6 hips with a Summit stem. Conclusion: The clinical and radiological evaluations in both systems showed excellent outcomes at the three year follow-ups, and there was no statistical difference on the clinical and radiological results between the two groups. Thigh pain and cortical hypertrophy were not detected in the Bencox stem, and that wound would be caused by surface treatment methods of the femoral stem, and morphological differences.
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