무시멘트형 비구컵 주위에 발생한 골용해
Osteolysis around Cementless Acetabular Component
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목적: Harris-Galante 2형 무시멘트 비구컵 주위에 발생한 골용해에 영향을 미치는 인자들을 분석하고자 하였다. 대상 및 방법: 1991년부터 1994년 사이에 Harris-Galante 2형 무시멘트 비구컵과 Multilock 대퇴스템을 이용하여 인 공고관절 전치환술을 시행하고 10년이상 추시가 가능하였던 44례를 대상으로 비구컵 주위에 발생한 골용해 발생빈도와 연령, 성별, 체중, 원인, 비구컵의 경사각, 폴리에틸렌 라이너의 두게, 폴리에틸렌 라이너의 선상 마모율과 골용해 발생 과의 관계를 분석하였다. 결과: 총 44례중 18례(40.9%)에서 비구컵 주위에 골용해가 발생하였으며, Charnley와 DeLee의 2구역에서 16례로 가장 많이 발생하였다. 연령, 성별, 체중, 원인, 비구컵의 경사각과 골용해는 통계학적으로 의미있는 차이는 없었으나 폴 리에틸렌 라이너의 두게, 폴리에틸렌 라이너의 선상 마모율과는 통계적으로 유의성이 있었다. 결론: Harris-Galante 2형 무시멘트형 비구컵을 이용한 인공고관절 전치환술을 시행하고 10년이상 추시시 비구컵 주위 의 골용해 발생 빈도는 시간이 지남에 따라 증가하였고 폴리에틸렌 라이너의 두께, 폴리에틸렌 라이너의 선상 마모율이 골용해 발생에 영향을 미치는 것으로 나타났으며 잠금 장치가 개선된 비구컵과 폴리에틸렌 라이너의 개선 및 세라믹이나 금속과 같은 관졀면의 사용이 필요할 것으로 사료된다.
Abstract
P u r p o s e: The purpose of this study was to evaluate the factors that have an influence on the osteolysis of cementless acetabular components (Harris-Galante type 2). Material and Method: From 1991 to 1994, 36 patients (44 cases) of total hip arthroplasty using a Multilock femoral stem and a Harris-Galante type 2 acetabular cup were reviewed with minimal follow-up period of 10 years. The relationship between the osteolysis and several factors such as the age, gender, weight, etiology, inclination, polyethylene liner thickness and wear rate were analyzed. Results: Osteolysis around the acetabular cup was found in 18 cases (40.9%). The most common area where this developed was zone 2 (16 cases, 36.4%). There was no statistically significant relationship between the age, gender, weight, etiology, inclination angle and the osteolysis. However, there was statistically significant correlation between the polyethylene liner thickness, wear rate and osteolysis. The average polyethylene liner thickness was 7.1 mm in cases with osteolysis and 8.1 mm in cases without osteolysis. The average wear rate was 0.26 mm/year in the osteolysis group, and 0.14 mm/year in the non-osteolysis group. C o n c l u s i o n: The incidence of osteolysis in the cementless acetabular component (Harris-Galante type 2) may increase as the follow-up period increases, and it was significantly related to the thickness and wear rate of the polyethylene liner. We suggest that the acetabular component needs an improved locking mechanism, improvement for the polyethylene liner longevity, and a ceramic or metal bearing surface is needed.
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