VerSys fiber metal tapered대퇴 주대를 사용한 고관절 전치환술의 중기 추시 결과
Midterm Results of Total Hip Arthroplasty Using the VerSys Fiber Metal Tapered Femoral Stem
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목적: VerSys fiber metal tapered 대퇴 주대를 이용한 무시멘트 고관절 전치환술을 시행한 환자를 대상으로 임상 및 방사선학적 결과를 분석하였다. 대상 및 방법: 최소 4년 이상 추시 관찰이 가능하였던 37고관절(31명)을 대상으로 하였으며 평균 추시 기간은 56개월(48-96개월)이었고 환자 평균 연령은 47.9세 였다. 임상적으로 Harris 고관절 점수와 대퇴부 동통의 유무를 평가하였고, 방사선학적 결과는 대퇴 주대의 고정 상태, 응력차단, 피질골 비후, 대퇴 주대 주위의 방사선 투과선 등을 분석하였다. 결과: 최종 추시에서 Harris 고관절 점수는 평균90.7점(82-99점)이었으며 대퇴부 동통은 6예(16%)에서 있었다. 32예(86.5%)에서 대퇴 근위부 응력 차단에 의한 골 흡수 현상이 관찰되었다. 피질골 비후는 16예(43.2%)에서 관찰되었으며, 2등급이상의 응력 차단 현상과 통계적인 관련성을 보였다. 최종 추시시 36예(97.2%)에서 골성 고정을 보였다. 결론: VerSys fiber metal tapered 대퇴 주대의 중기 추시 관찰 결과 임상적으로 우수한 결과를 보여 주었고 방사선학적으로 초기 안정적인 고정과 신생골 형성에 있어 우수한 결과를 보여주고 있으나, 응력 차단에 의한 근위부 대퇴부 골흡수의 빈도가 높아 이에 대해 장기 추시가 필요할 것으로 사료된다.
Abstract
Purpose: We evaluated the clinical and radiological results of patients who received the cementless VerSys fiber metal tapered stem for total hip arthroplasty. Materials and Methods: Thirty seven hip joint replacements(31 patients) were evaluated over a minimum four year period following the procedure with an average follow-up period of 56 months(48-96 months). The mean patient age was 47.9 years old. Clinical results were analyzed using Harris hip scores, incidence of thigh pain and radiographic analysis was used to assess fixation of the stem, stress shielding, cortical hypertrophy and radiolucent lines around the femoral stem. Results: The average Harris hip score was 90.7 points(82-99 points). Thigh pain was noticed in 6 hips(16%). Proximal femoral bone resorption by stress shielding was observed in 32 hips(86.5%). Cortical hypertrophy was noticed in 16 hips(43.2%) and was statistically correlated with stress shielding of 2nd degree or more according to the Engh classification. Stable bone ingrowth at the last follow-up was seen in 36 hips(97.2%). Conclusion: Cementless total hip arthroplasty using the cementless VerSys fiber metal tapered stem demonstrated excellent midterm clinical results as well as excellent radiologic results for stable fixation and endosteal new bone formtion. However, long term follow-up evaluation will be required because of the high rates of proximal bone resorption by stress shielding.
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