세라믹 샌드위치 라이너를 이용한 인공고관절 전치환술
Total Hip Replacement Arthroplasty Using Ceramic Sandwich Liner
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목적: 세라믹 샌드위치 라이너를 이용한 인공 고관절 전치환술의 2년 이상 추시 결과를 분석하고자 한다. 대상 및 방법: 1999년 2월부터 2001년 10월까지 세라믹 샌드위치 라이너를 이용하여 인공 고관절 전치환술을 시행한 환자 97명 중 2년 이상 추시가 가능하였던 79명, 82예의 고관절을 대상으로 하였다. 수술 시 평균 연령은 48.7세(범 위, 19세부터 57세까지), 성별은 남자 43명, 여자 36명, 평균 추시 기간은 40개월(범위, 24개월부터 56개월까지)이었 다. 술전 진단은 대퇴골두 무혈성 괴사가 47예, 퇴행성 고관절염이 14예, 외상성 관절염이 8예, 화농성 고관절염 후유 증 6예, 결핵성 고관절염 후유증 2예, 류마토이드 관절염 3예, 강직성 척추염 2예였다. 결과: 임상적 평가로 Harris 고관절 점수는 술전 평균 55점에서 술후 평균 94.5점으로 향상되었다. 합병증은 감염성 해 리 2예, 반복적 탈구 1예, 이소성 화골증 1예였으며, 감염증 및 반복적 탈구는 재수술을 시행하였다. 결론: 세라믹 샌드위치 라이너를 이용한 인공고관절 전치환술 단기 추시에서는 양호한 결과를 보였고, 세라믹 부품의 파 손이나 골용해 등의 합병증은 없었다. 그러나 추후 장기 추적을 통한 경과 관찰이 필요할 것으로 사료된다.
Abstract
Purpose: This study was undertaken to evaluate the minimum 2-year results of total hip replacement arthroplasty using a ceramic sandwich liner. Materials and Methods: From February 1999 to October 2001, 97 consecutive hip arthroplasty implants(male 55, female 42) with a ceramic-ceramic coupling were carried out at our department. Of them, only 79 cases (male 43, female 36, 82 hips) had the complete clinical and radiographic data at an average follow up of 40 months(range, 24~56 months). Their mean age was 48.7years (range, 19~57years). The Harris hip score was used for the clinical evaluation. X-rays were examined according to the DeLee and Charnley method. The initial diagnoses were osteonecrosis of the femoral head in 47 cases, osteoarthritis in 14 cases, posttraumatic arthritis in 8 cases, septic arthritis sequela in 6 cases, tuberculous arthritis sequela in 2 cases, rhrumatoid arthritis in 3 cases and ankylosing spondylitis in 2 cases. Results: For them, a good clinical result(average HHS 94.5) was recorded, and no acetabular radiolucency could be detected on the X-ray images. At the minimum 2-year follow up, the result of this ceramic cup are quite encouraging. Infectious osteolysis at the femoral stem occurred in two cases. Anterolateral recurrent dislocation and heterotopic ossification occurred in one case respectively, but there were no cases of ceramic failure. Conclusion: The short term results of total hip replacement arthroplasty using a ceramic sandwich liner were quite promising, but a longer follow-up will be needed.
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