인공 고관절 치환술에서의 무시멘트 인공 삽입물
Cementless Implant in Total Hip Arthroplasty
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인공 고관절 치환술에 사용되는 인공 삽입물은 디자인과 고정방식의 형태에 따라 다양하게 나눌 수 있다. 크게 시멘트형과 무시멘트형으로 나눌 수 있으며, 술자는 인공 고관절 치환술의 목적, 환자의 골 형태, 환자의 기능 그리고 자신의 경험에 따라 어떠한 삽입물을 사용할 것인지를 결정하여야 한다. 무시멘트형 인공관절의 일차적 고정과 생존율 그리고 장기 추시 상에서의 성공적인 고정은 인공 삽입물의 재질, 삽입되는 골의 상태 그리고 궁극적으로 인공 삽입물과 골 사이의 상호반응에 달려 있다. 무시멘트형 인공 삽입물은 일차성 고관절 치환술에서 높은 성공률을 보이고 있으며 장기 추시상에서도 비교적 양호한 결과를 보이고 있다. 시멘트형 인공 삽입물과 비교하여 어떠한 삽입물이 우수하다고 할 수는 없으나, 인공 고관절 치환술의 목적, 환자의 골 형태, 환자의 기능 그리고 술자의 경험을 바탕으로 인공 삽입물을 선택하면 좋은 결과를 얻을 수 있을 것이다. 따라서 인공 고관절 치환술에서의 무시멘트 인공 삽입물의 특성과 적용, 시술, 그리고 그에 따른 임상적 결과에 대하여 정리해 보고자 한다.
Abstract
The various implants used in total hip arthroplasty can be classified according to the design and the fixation type. In general, they can be divided into two groups; cemented and cementless types. The surgeon’s decision regarding which type of implant to use should be based on the goal of the arthroplasty operation, the bony deformity of the patient, the function of the involved hip joint, and the experience of the operator. When using cementless implants, primary fixation, survival rate, and successful fixation on long-term follow-up depend on the material of the implant, the bone quality, and, ultimately, the interaction between the implant and the bone. Cementless implants have shown a high success rate in primary total hip arthroplasty and relatively fine outcomes on long-term follow-up. In comparison of the two implant types, superiority has yet to be determined,however, a choice made based on the objective of the surgery, the function of the joint, the quality of the bone, and the surgeon's experience will result in a good outcome. Therefore, we reviewed the qualities of cementless implants, the application, and the various procedures involving the implant.
참고문헌 (34)
- Welch RB, "Low friction arthroplasty of the hip in rheumatoid arthritis and ankylosing spondylitis", Clin Orthop Relat Res, 72, pp.22~32 (1970)
- Götze C, "Primary stability in cementless femoral stems: custom- made versus conventional femoral prosthesis", Clin Biomech (Bristol, Avon), 17, pp.267~273 (2002)
- Petersen MB, "The hemispherical Harris-Galante acetabular cup, inserted without cement. The results of an eight to eleven-year follow-up of one hundred and sixty-eight hips", J Bone Joint Surg Am, 81, pp.219~224 (1999)
- Ochs U, "Prospective long-term follow-up of the cementless bicontact hip stem with plasmapore coating", Z Orthop Unfall, 145(Suppl 1), pp.S3~S8 (2007)
- Costa CR, "Use of cementless, tapered femoral stems in patients who have a mean age of 20 years", J Arthroplasty, 27, pp.497~502 (2012)
- Keisu KS, "Primary cementless total hip arthroplasty in octogenarians. Two to eleven-year follow- up", J Bone Joint Surg Am, 83(A), pp.359~363 (2001)
- Kim YH, "Contemporary total hip arthroplasty with and without cement in patients with osteonecrosis of the femoral head: a concise follow-up, at an average of seventeen years, of a previous report", J Bone Joint Surg Am, 93, pp.1806~1810 (2011)
- Labek G, "Outcome of the cementless Taperloc stem", Acta Orthop, 82, pp.633~634 (2011)
- Sakalkale DP, "Minimum 10-year results of a tapered cementless hip replacement", Clin Orthop Relat Res, (362), pp.138~144 (1999)
- 허창익, "활동성 고령 환자에서 발생한 급성 전위성 대퇴 경부 골절에 대한 최소 침습 두 부위 절개 고관절 전치환술", 대한정형외과학회지, 43(5), pp.643~650 (2008), 대한정형외과학회
- Callaghan JJ, "The clinical results and basic science of total hip arthroplasty with porous-coated prostheses", J Bone Joint Surg Am, 75, pp.299~310 (1993)
- Haddad RJ Jr, "Biological fixation of porous-coated implants.", J Bone Joint Surg Am, 69, pp.1459~1466 (1987)
- Peters CL, "The cementless acetabular component, In The adult hip", pp.993~1016 (1998), Lippincott-Raven
- Robinson RP, "Uncemented total hip arthroplasty using the CLS stem: a titanium alloy implant with a corundum blast finish. Results at a mean 6 years in a prospective study", J Arthroplasty, 11, pp.286~292 (1996)
- Pilliar RM, "Porous surfaced metallic implants for orthopaedic applications", J Biomed Mater Res, 21, pp.1~33 (1987)
- Bourne RB, "Ingrowth surfaces. Plasma spray coating to titanium alloy hip replacements", Clin Orthop Relat Res, (298), pp.37~46 (1994)
- Hahn H, "Preliminary evaluation of porous metal surfaced titanium for orthopaedic implants", J Biomed Mater Res, 4, pp.571~577 (1970)
- Spotorno L, "The CLS system. Theoretical concept and results.", Acta Orthop Belg, 59(Suppl 1), pp.144~148 (1993)
- Vervest TM, "Ten to twelve-year results with the Zweymuller cementless total hip prosthesis", J Arthroplasty, 20, pp.362~368 (2005)
- Bliss JM, "Hydroxyapatite- coated femoral stem", porous-coated acetabulum survivorship at 15 years, 2011, pp.26, 972~975
- Oonishi H, "The effect of hydroxyapatite coating on bone growth into porous titanium alloy implants", J Bone Joint Surg Br, 71, pp.213~216 (1989)
- Schimmel JW, "Primary fit of the Lord cementless total hip. A geometric study in cadavers.", Acta Orthop Scand, 59, pp.638~642 (1988)
- Annaz B, "Porosity variation in hydroxyapatite and osteoblast morphology : a scanning electron microscopy study", J Microsc, 215, pp.100~110 (2004)
- Nishiguchi S, "Titanium metals form direct bonding to bone after alkali and heat treatments", Biomaterials, 22, pp.2525~2533 (2001)
- Ong KL, "Acetabular cup geometry and bone-implant interference have more influence on initial periprosthetic joint space than joint loading and surgical cup insertion", J Biomech Eng, 128, pp.169~175 (2006)
- Effenberger H, "Factors influencing the revision rate of Zweymuller acetabular cup", Int Orthop, 28, pp.155~158 (2004)
- Bigsby E, "The medium term outcome of the Omnifit constrained acetabular cup", Hip Int, 22, pp.505~510 (2012)
- Ruben RB, "On the optimal shape of hip implants", J Biomech, 45, pp.239~246 (2012)
- Purtill JJ, "Total hip arthroplasty using two different cementless tapered stems", Clin Orthop Relat Res, (393), pp.121~127 (2001)
- Berry DJ, "Evolution of uncemented femoral component design, In Hip Society, Knee Society, American Academy of Orthopaedic Surgeons, eds. Orthopaedic knowledge update: hip and knee reconstruction, 2", pp.117~127 (2000), American Academy of Orthopaedic Surgeons
- Khanuja HS, "Cementless femoral fixation in total hip arthroplasty", J Bone Joint Surg Am, 93, pp.500~509 (2011)
- Engh CA, "The odyssey of porous-coated fixation", J Arthroplasty, 17, pp.102~107 (2002)
- Chiu KY, "Cementless total hip arthroplasty in young Chinese patients : a comparison of 2 different prostheses", J Arthroplasty, 16, pp.863~870 (2001)
- Ellison B, "Tapered titanium porous plasma-sprayed femoral component in patients aged 40 years and younger", J Athroplasty, 21, pp.32~37 (2006)