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Accolade TMZF 대퇴 스템을 이용한 무시멘트형 고관절 전치환술의 단기 임상 결과

Short Term Results of Cementless Total Hip Arthroplasty with Using a Accolade TMZF Femoral Stem

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목적: Accolade TMZF 대퇴 스템을 이용한 무시멘트형 고관절 전치환술의 단기적 임상 및 방사선 결과, 합병증을 평가하고자 하였다. 대상 및 방법: 2002 년 1월부터 2006년 2 월까지 약 4 년 1개월 간 단일 술자에 의해서 Accolade TMZF 대퇴 스템과 세라믹- 세라믹 관절면을 이용한 고관절 전치환술을 시행 받은 80 예 중 30 개월 이상 추시된 66 예를 후향적으로 분석 하였다. 결과: 임상적 결과로 Harris 고관절 점수는 술전 평균 54 점에서 최종 추시시 92 점으로 향상되었으며, 대퇴부의 최종 추시 방 사선 소견상 전례(100%)에서 안정적 고정 소견을 보였고 스템의 해리, 골용해 등은 없었으며, 34 예의 근위 대퇴골 흡수, 20 예의 피질골 비후가 있었고, 비구컵은 65 예에서 안정고정(98.5%), 1 예(1.5%)에서 해리로 진단되었고, 비구 골흡수는 De Lee의 II 구역에서만 22 예 관찰되었다. 합병증으로 5 예의 이소성 골화, 2 예의 탈구, 1 예의 대전자 윤활낭염과 2 예의 대퇴부 동통, 1 예의 squeaking sound가 있었다. 결론: Accolade TMZF 대퇴 스템을 이용한 무시멘트형 고관절 전치환술의 단기 추시 결과 양호한 결과를 얻었으나 장기 추시 를 요할 것으로 사료된다.

Abstract

Purpose: We wanted to evaluate the short term clinical and radiological results and the complications of primary total hip arthroplasty with using a Accolade TMZF femoral stem. Materials and Methods: 66 cases among 80 cases underwent total hip arthroplasty by one surgeon with using an Accolade TMZF femur stem from January 2002 to August 2006. The minimum follow-up was 30 months and we retrospectively analyzed these 66 patients. Results: The mean Harris Hip Score improved from 54 to 92 at the last follow up. On the last follow-up X-ray, all the femoral stems (100%) showed stable fixation and there was no osteolysis or loosening, but there were 34 cases of stress shields and 20 cases of cortical hypertrophy. The acetabular component revealed stable fixation in 65 cases (98.5%) and loosening in one case (1.5%). There was no acetabular osteolysis, but 22 cases of radiolucency were observed in the Dee Lee and Charnley zone II. As complications, there were 5 cases of heterotrophic ossification, 1 case of greater trochanteric bursitis, 2 cases of thigh pain and 1 case with a squeaking sound. Conclusion: Primary total hip arthroplasty using a cementless Accolade TMZF femoral stem showed good results in the short term, but long term follow up is needed.

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