인공고관절 재치환술에서 안정적으로 고정된 금속 비구컵에 시멘트를 이용한 폴리에틸렌 라이너 고정술의 단기 추시 결과
Short Term Results of Cementation of a Polyethylene Liner into a Well-Fixed Metal Shell
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목적: 인공고관절 재치환술에서 안정적으로 고정되어 있는 비구컵에 시멘트를 이용하여 라이너 를 고정하는 술식에 대하여 임상적 및 방사선학적 결과를 평가하고자 하였다. 대상 및 방법: 2001년 11월부터 2006년 4월까지 10명의 환자, 11예를 대상으로 하였다. 재치환 술시의 평균연령은 54.3세였으며 남자가 5명(6예), 여자가 5명 이었다. 이들의 평균 추시 기간은 35.2개월 이었다. 재치환술시 모든 비구컵은 안정적으로 고정되어 있었으며 비교적 만족스러운 위치를 보였다. 비구컵의 나사는 제거하고, 나사 구멍을 동종골로 채웠다. 비구컵의 내측면과 라 이너의 후방면은 고속 천공기를 이용하여 홈을 만들어 주었다. 임상적 결과의 평가는 Harris hip score (HHS)로 하였고 방사선적 결과는 비구컵과 라이너의 위치 변화 및 점진적인 골 용해의 변 화로 평가하였다. 결과: HHS는 술전 69.5점에서 최종 추시시 89.2점으로 향상 되었다. 방사선 소견에서 비구컵과 라이너의 위치 변화는 보이지 않았으며 대퇴 삽입물 및 비구컵 주위 골 용해의 진행은 없었다. 결론: 인공고관절 재치환술시 이 술식은 단기추시에서 만족할 만한 결과를 나타내었다.
Abstract
Purpose: To evaluate the radiological and clinical results of cementation of a polyethylene liner into a well-fixed metal shell in revision total hip arthroplasty. Materials and Methods: From November 2001 to April 2006, 11 cases (10 patients) were included in this study. There were 5 males (6 cases) and 5 females with a mean age of 54.3 years. The mean follow-up period was 35.2 months. The acetabular shells were stable and their position was acceptable in all cases. Pre-existing screws were removed and screw holes were filled with allogenic bone. The inner surface of the metal shells and convex backside of the liners were roughened with a burr. The clinical results were evaluated using the Harris hip score (HHS) and the radiological results with evidence of a positional change in the acetabular cup and liner, and the progression of osteolysis around the cup. Results: The mean HHS was 69.5 points preoperatively and 89.2 at the last follow up. There was no change in the cup and liner position or progression of the osteolytic lesion around the femoral or acetabular components. Conclusion: Cementation of a polyethylene liner into a well-fixed metal shell showed satisfactory results in revisional total hip arthroplasty with a short term follow-up period.
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