Harris-GalanteⅡ 비구컵에서 발생한 Polyethylene Liner Dissociation과 관련된 인자
Factors associated with Polyethylene Liner Dissociation of Harris-GalanteⅡ Acetabular Component
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Harris-Galante II 비구컵을 사용한 인공 고관절 치환술 후 발생한 폴리에틸렌 라이너 분리에 관련된 인자를 대 조군과의 비교 연구를 통하여 분석하고자 하였다. 대상 및 방법: 1992년 1월부터 1996년 1월까지 Harris-Galante II 비구컵을 사용하여 인공 고관절 치환술을 시행한 환자 중 추시기간 중 라이너 분리가 발생한 14예를 분리군 으로 하였고, 10년 이상 추시에서 라이너 분리가 발생하지 않 고 임상적 결과가 좋은 30예를 비분리군 으로 하여 임상적, 방사선학적으로 후향적으로 비교 분석하였다. 결과: 임상적 인자중 두 군간 통계학적 유의성을 보인 것은 없었으며, 인공 고관절 기구와 방사선학적 인자중 비구컵의 크기(분리군: 53.1 mm, 비분리군: 55.6 mm), 라이너의 두께(분리군: 7.1 mm, 비분리군: 8.1 mm)와 비구컵의 경 사도(분리군: 49.6°, 비분리군: 45.9°)에서 두군 간 통계학적으로 유의성을 보였다(P<0.05). 결론: 라이너 분리의 방지를 위해서는 잠금 장치가 좋은 비구컵이라도 가능하면 수술시 비구컵의 경사도를 정상 보다 크지 않게 시술하도록 하고, 작은 비구컵 및 얇은 라이너를 사용했을 경우에는 조심스런 환자 관리가 필요할 것으로 사료된다.
Abstract
P u r p o s e: To analyze the factors associated with the polyethylene liner dissociation following a total hip arthroplasty using a Harris-Galante II acetabular component through a comparative study. Material and Methods: The dissociation group involved a total of 14 cases who developed a liner dissociation after applying total hip arthroplasty using a Harris-Galante II acetabular component between January 1992 and January 1996. The non-dissociation group involved 30 cases, who were defined as those who did not develop a liner dissociation and showed a well maintained prosthesis for 10 years free from remarkable complications. The abovementioned groups were retrospectively cross analyzed clinically and radiologically. Results: There was no statistical significance in the clinical factors. However, a statistical significance was noted in the acetabular cup size (dissociation group: 53.1mm, Non-dissociation group: 55.6mm), the liner thickness(dissociation group: 7.1mm, Non-dissociation group: 8.1mm), and the acetabular inclination angle(dissociation group: 49.6°D, Non-dissociation group: 45.9°D) (P<0.05). Conclusion: In order to prevent the liner dissociation, the inclination should not exceed an acceptable range, even though the cup has a better locking mechanism. In addition, it is believed that more vigilant postoperative patient management is essential, particularly if a small cup and a thinner liner are incorporated in the procedure.
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