대퇴골두 무혈성 괴사 환자에 대한 양극성 인공고관절 반치환술
Bipolar Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head
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목적: AML 무시멘트 대퇴 스템을 이용한 양극성 인공 고관절 반치환술을 시행한 대퇴 골두 무혈성 괴사 환자들의 임상 적, 방사선학적 치료 결과를 보고하고자 한다. 대상 및 방법: 1994년부터 1998년 까지 대퇴 골두 무혈성 괴사 환자에서 AML 무시멘트 대퇴스템을 이용한 양극성 인공 고관절 반치환술을 시행 받은 환자 중 5년 이상 추시가 가능했던 환자 20명 22예를 대상으로 수술 후 임상적, 방사선적 결과를 분석하였다. 결과: 총 20명중 남자 13명, 여자 7명 이었고, 평균 추시시간은 6년 2개월로 수술 당시 평균연령은 49세였고 Harris Hip score를 사용한 임상적 결과로는 술 전 53,5점에서 87.9점으로 향상된 결과를 얻었으며, 서혜부 및 대퇴 동통은 총 3예 (17%)에서 발생되었다. 방사선적 결과롤 비구의 근위부이동이 1 예에서 보였으며 대퇴 삽입물은 안정적인 고정 을 보여주었다. 결론: 대퇴 골두 무혈성 괴사 환자의 치료로 시행한 AML 무시멘트 양극성 인공 고관절 반치환술은 비교적 낮은 합병증 과 임상적, 방사선학적 안정성을 고려해 볼 때 만족스러운 치료 결과을 얻을 수 있을 것으로 사료된다.
Abstract
P u r p o s e: We wished to analyze the clinical and radiological results of bipolar hip arthroplasty using AML cementless stems in patients with osteonecrosis of the femoral head. Materials and Methods: Between 1994 and 1998, 20 patients who underwent bipolar prosthetic replacement using AML cementless stems for osteonecrosis of the femoral head. We retrospectively reviewed and analyzed the clinical and radiological results of 22 hips of 20 patients, and the minimum follow-up period was 5 years. Results: The twenty patients included 13 men and 7 women. The mean duration of follow-up was 6 years and 2 months. The mean patient age was 49 years. The mean Harris hip score was improved from preoperative 53.5 points to 87.9 points at the latest follow up. Three patients (17%) had complaints about groin or thigh pain. One hip (5%) developed acetabulum migration. All the femoral stems remained stable. Conclusion: AML cementless bipolar hip arthroplasty for osteonecrosis of the femoral head produced satisfactory clinical and radiologic results on this follow-up study, and there was a relatively low rate of complications.
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