본문 바로가기
KERD
논문KCI 등재

Long-Term Follow-Up Results of a Second-Generation Cementless Femoral Prosthesis with a Collar and Straight Distal Fixation Channels

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: We evaluated the results of more than 10 years of follow-up of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels. Materials and Methods: One hundred five patients (129 hips) who underwent surgery between 1991 and 1996 for primary total hip arthroplasty using cementless straight distal fluted femoral stems were followed for more than 10 years. Ninety-four hips in 80 patients were available for clinical and radiologic analysis. The mean age at the time of surgery was 47 years, and the mean duration of follow-up was 14.3 years. Results: The mean Harris hip scores had improved from 58 points to 88 points at the time of the 10-year follow-up. Activity-related thigh pain was reported in nine hips (10%). At the last follow-up, 93 stems (99%) were biologically stable and one stem (1%) was revised because of loosening. No hip had distal diaphyseal osteolysis. Proximal femoral stress-shielding was reported in 86 hips (91%). We found no significant relationship between collar-calcar contact and thigh pain, stem fixation status, or stress-shielding. The cumulative survival of the femoral stem was 99% (95% confidence interval, 98-100%) after 10 years. Conclusion: The long-term results of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels were satisfactory; however, the high rate of proximal stress-shielding and the minimal effect of the collar indicate the need for some changes in the stem design.

Abstract

Purpose: We evaluated the results of more than 10 years of follow-up of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels. Materials and Methods: One hundred five patients (129 hips) who underwent surgery between 1991 and 1996 for primary total hip arthroplasty using cementless straight distal fluted femoral stems were followed for more than 10 years. Ninety-four hips in 80 patients were available for clinical and radiologic analysis. The mean age at the time of surgery was 47 years, and the mean duration of follow-up was 14.3 years. Results: The mean Harris hip scores had improved from 58 points to 88 points at the time of the 10-year follow-up. Activity-related thigh pain was reported in nine hips (10%). At the last follow-up, 93 stems (99%) were biologically stable and one stem (1%) was revised because of loosening. No hip had distal diaphyseal osteolysis. Proximal femoral stress-shielding was reported in 86 hips (91%). We found no significant relationship between collar-calcar contact and thigh pain, stem fixation status, or stress-shielding. The cumulative survival of the femoral stem was 99% (95% confidence interval, 98-100%) after 10 years. Conclusion: The long-term results of total hip arthroplasty using a second-generation cementless femoral prosthesis with a collar and straight distal fixation channels were satisfactory; however, the high rate of proximal stress-shielding and the minimal effect of the collar indicate the need for some changes in the stem design.

참고문헌 (35)

  1. Salvati EA, "A ten-year follow-up study of our first one hundred consecutive Charnley total hip replacement", J Bone Joint Surg Am, 63, pp.753~767 (1981)
  2. Sutherland CJ, "A ten-year follow-up of one hundred consecutive Muller curved-stem total hip-replacement arthroplasties", J Bone Joint Surg Am, 64, pp.970~982 (1982)
  3. Stauffer RN, "Ten-year follow-up study of total hip replacement", J Bone Joint Surg Am, 64, pp.983~990 (1982)
  4. Galante JO, "New developments in hip arthroplasty. Overview of current attempts to eliminate methylmethacrylate", Hip, 1983, pp.181~189 (1983)
  5. Pilliar RM, "Observations on the effect of movement on bone ingrowth into porous-surfaced implants", Clin Orthop Relat Res, 1986, pp.108~113 (1986)
  6. Engh CA, "Cementless total hip arthroplasty using the anatomic medullary locking stem. Results using a survivorship analysis", Clin Orthop Relat Res, 1989, pp.141~158 (1989)
  7. Engh CA, "Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results", J Bone Joint Surg Br, 69, pp.45~55 (1987)
  8. Engh CA, "The influence of stem size and extent of porous coating on femoral bone resorption after primary cementless hip arthroplasty", Clin Orthop Relat Res, pp.7~28 (1988)
  9. Pellegrini VD Jr, "A collarless cobalt-chrome femoral component in uncemented total hip arthroplasty. Five- to eight-year follow-up", J Bone Joint Surg Br, 74, pp.814~821 (1992)
  10. Xenos JS, "The porous-coated anatomic total hip prosthesis, inserted without cement. A prospective study with a minimum of ten years of follow-up", J Bone Joint Surg Am, 81, pp.74~82 (1999)
  11. Clohisy JC, "The Harris-Galante uncemented femoral component in primary total hip replacement at 10 years", J Arthroplasty, 14, pp.915~917 (1999)
  12. Kawamura H, "The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty", J Bone Joint Surg Am, 83(A), pp.1333~1338 (2001)
  13. Schmalzried TP, "Periprosthetic bone loss in total hip arthroplasty. Polyethylene wear debris and the concept of the effective joint space", J Bone Joint Surg Am, 74, pp.849~863 (1992)
  14. Kim YH, "Uncemented porous-coated anatomic total hip replacement. Results at six years in a consecutive series", J Bone Joint Surg Br, 75, pp.6~13 (1993)
  15. Sinha RK, "Primary total hip arthroplasty with a proximally porous-coated femoral stem", J Bone Joint Surg Am, 86(A), pp.1254~1261 (2004)
  16. Lachiewicz PF, "Second-generation proximally coated titanium femoral component: minimum 7-year results", Clin Orthop Relat Res, 465, pp.117~121 (2007)
  17. Surdam JW, "A second-generation cementless total hip arthroplasty mean 9-year results", J Arthroplasty, 22, pp.204~209 (2007)
  18. Harris WH, "Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation", J Bone Joint Surg Am, 51, pp.737~755 (1969)
  19. Meding JB, "Comparison of collared and collarless femoral components in primary uncemented total hip arthroplasty", J Arthroplasty, 12, pp.273~280 (1997)
  20. Gruen TA, "“Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening", Clin Orthop Relat Res, pp.17~27 (1979)
  21. Johnston RC, "Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results", J Bone Joint Surg Am, 72, pp.161~168 (1990)
  22. Engh CA, "Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components", Clin Orthop Relat Res, pp.107~128 (1990)
  23. Campbell AC, "Thigh pain after cementless hip arthroplasty. Annoyance or ill omen", J Bone Joint Surg Br, 74, pp.63~66 (1992)
  24. Livermore J, "Effect of femoral head size on wear of the polyethylene acetabular component", J Bone Joint Surg Am, 72, pp.518~528 (1990)
  25. Min BW, "Second-generation cementless total hip arthroplasty in patients with osteonecrosis of the femoral head", J Arthroplasty, 23, pp.902~910 (2008)
  26. Dorr LD, "Failure mechanisms of anatomic porous replacement I cementless total hip replacement", Clin Orthop Relat Res, pp.157~167 (1997)
  27. Goetz DD, "The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. A retrospective matched-pair series", J Bone Joint Surg Am, 76, pp.1121~1129 (1994)
  28. Martell JM, "Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement", J Bone Joint Surg Am, 75, pp.554~571 (1993)
  29. Bobyn JD, "The optimum pore size for the fixation of porous-surfaced metal implants by the ingrowth of bone", Clin Orthop Relat Res, pp.263~270 (1980)
  30. Meding JB, "Minimum ten-year follow-up of a straight-stemmed, plasma-sprayed, titanium-alloy, uncemented femoral component in primary total hip arthroplasty", J Bone Joint Surg Am, 86(A), pp.92~97 (2004)
  31. Kim YH, "Results of the Harris-Galante cementless hip prosthesis", J Bone Joint Surg Br, 74, pp.83~87 (1992)
  32. Maloney WJ, "Endosteal erosion in association with stable uncemented femoral components", J Bone Joint Surg Am, 72, pp.1025~1034 (1990)
  33. Mallory TH, "Why a taper?", J Bone Joint Surg Am, 84(A Suppl 2), pp.81~89 (2002)
  34. Sano K, "Changes of bone mineral density after cementless total hip arthroplasty with two different stems", Int Orthop, 32, pp.167~172 (2008)
  35. Klein GR, "Total hip arthroplasty with a collarless, tapered, fiber metal proximally coated femoral stem: minimum 5-year follow-up", J Arthroplasty, 24, pp.579~585 (2009)

관련 논문AI추천

이 간행물의 다른 논문 (18건)