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Fiber Metal Taper 대퇴 스템과 Trilogy 비구컵을 이용한일차성 무시멘트 고관절 전치환술의 중기 추시 관찰

Mid-term Results of Primary Cementless Total Hip Arthroplastywith a Fiber Metal Taper Femoral Component and Trilogy Acetabular Cup

이정섭|신종기|서근택
대한고관절학회 (The Korean Hip Society)|2008.03|Hip and Pelvis|제20권 제1호|pp. 59-69

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Total hip arthroplastyCementless무시멘트형 고관절 전치환술Fiber Metal Taper 대퇴스템Trilogy 비구컵Fiber Metal Taper stemTrilogy cup

초록

목적: 본 연구의 목적은 환형 미세공 근위부 피복 및 원위 원추형 대퇴 스템과 미세공 피복 비구컵을 이용한 고관절 전치환술 후 5년 이상의 추시 결과의 분석이다. 대상 및 방법: 1998년 9월부터 2001년 12월까지 Versys Fiber Metal Taper 대퇴 스템(Zimmer, Warsaw, IN) 및 무시멘트 Trilogy 비구컵(Zimmer)을 사용하여 고관절 전치환술을 시행 받고, 최소 5년 이상 추시 관찰이 가능하였던 52명 57예를 대상 으로 하였다. 평균 연령 46.7세, 평균 추시 기간 5.6년이었고 임상적 방사선학적 평가를 시행하였다. 결과: 평균 Harris 고관절 점수는 술 전 56.6점에서 최종 추시 시 96.0점이었다. 대퇴 스템의 위치의 변화나 수직 하강은 발생하 지 않았다. 최종 추시시 대퇴 스템의 골내막 골형성은 주로 Gruen 제 2, 6구역에서 53예(92.9%)가 나타났으며, 대퇴부 골용해 는 없었다. 비구컵의 수직, 수평 이동이나 경사각의 의미있는 변화 및 비구컵 주위의 골용해는 관찰되지 않았다. 무균성 해리로 인한 재치환술의 시행 여부를 고려한 대퇴 스템 및 비구부의 생존율은 100%이었다. 결론: Fiber Metal Taper 대퇴 스템과 Triology 비구컵을 이용한 고관절 전치환술은 최소 5년 추시 결과 안정된 골성 고정을 보 였으며 대퇴부와 비구컵 주위 골용해가 없어 우수한 임상적, 방사선학적 결과를 보였다. 향후 더 장기적인 추시 관찰이 요할 것 으로 사료된다.

Abstract

Purpose: This study examined the results of cementless total hip arthroplasty using a circumferentially porous coated tapered femoral stem and a porous coated acetabular cup after a follow up of more than 5 years. Materials and Methods: Fifty-seven hips in 52 patients, who underwent primary total hip arthroplasty with a Versys Fiber Metal Taper femoral stem (Zimmer, Warsaw, IN) and Trilogy acetabular cup (Zimmer) between September 1998 and December 2001, were followed up for more than 5 years after surgery. Results: The mean Harris hip score increased from 56.6 to 96.0 points. There was no osteolysis in the femur and acetabulum. Endosteal bone formation was observed in 53 hips (92.9%) mainly in Gruen zones II and VI. There was no stem subsidence, and no significant migration or tilting of the acetabular cup. The survival with an acetabular and femoral revision for aseptic loosening was 100%, respectively. Conclusion: After a follow-up of more than 5 years, cementless total hip arthroplasty using a circumferentially porous coated tapered femoral stem and a porous coated acetabular cup showed excellent results with good bone ingrowth, as well as no stem and cup migration and no osteolysis around the distal femur and acetabulum. However, a longer term follow up will be necessary.

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