Total Hip Arthroplasty with Extra-small Femoral Stems in Extremely Hypoplastic Femurs: A Case-Series Study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2024-06-26 DOI:10.4055/cios23377
Young-Seung Ko, Sang Yoon Kang, Hong Seok Kim, Jeong Joon Yoo
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引用次数: 0

Abstract

Background: Total hip arthroplasty (THA) in patients with hypoplastic femurs presents a significant challenge to orthopedic surgeons due to the limited space available for implant placement. Therefore, the extra-small femoral stems have been proposed as a solution to this problem, but there are limited data on the outcomes. We aimed to evaluate clinical and radiological outcomes of THA in patients with extremely hypoplastic femurs using the Bencox CM stem (Corentec), an extra-small femoral stem.

Methods: We included 6 hips from 4 patients. The mean age of the patients was 41.2 years (range, 19.6-60.4 years). The mean height was 135.1 cm (range, 113.6-150.0 cm) with a mean body mass index of 25.7 kg/m2 (range, 21.3-31.1 kg/m2). The diagnoses for THA were sequelae of septic arthritis in childhood, pseudoachondroplasia, spondyloepiphyseal dysplasia, and juvenile rheumatoid arthritis. Preoperative computed tomography scans were conducted to assess the extent of proximal femoral hypoplasia. The clinical outcomes were assessed using the modified Harris Hip Score, while the radiological outcomes were evaluated using radiographs. The mean follow-up was 2.3 years (range, 1.0-5.9 years).

Results: The average modified Harris Hip Score improved to 88.8 at the final follow-up. Intraoperative femoral fractures occurred in 2 cases (33.3%). During the follow-up, 1 stem underwent varus tilting from postoperative 6 weeks to 6 months without subsidence. Otherwise, all stems showed good osteointegration at the latest follow-up. No hip dislocations, periprosthetic joint infection, or loosening of the prosthesis occurred.

Conclusions: The use of extra-small femoral stems in THA for extremely hypoplastic femurs can provide reasonable clinical and radiological outcomes with minimal complications. We suggest that this femoral stem could be a viable option for patients with extremely hypoplastic femurs.

在股骨极度发育不良的患者中使用超小股骨柄的全髋关节置换术:病例系列研究。
背景:由于植入空间有限,股骨发育不良患者的全髋关节置换术(THA)给骨科医生带来了巨大挑战。因此,人们提出了超小股骨柄来解决这一问题,但有关其结果的数据却很有限。我们的目的是评估股骨极度发育不良患者使用超小型股骨柄 Bencox CM 茎(科伦特公司)进行 THA 的临床和放射学效果:我们纳入了 4 名患者的 6 个髋关节。患者的平均年龄为41.2岁(19.6-60.4岁)。平均身高为135.1厘米(范围为113.6-150.0厘米),平均体重指数为25.7千克/平方米(范围为21.3-31.1千克/平方米)。THA 的诊断为儿童期化脓性关节炎后遗症、假性软骨发育不良、脊柱骺发育不良和幼年类风湿性关节炎。术前通过计算机断层扫描评估股骨近端发育不良的程度。临床结果采用改良哈里斯髋关节评分进行评估,而放射学结果则采用X光片进行评估。平均随访时间为 2.3 年(1.0-5.9 年):结果:最终随访时,平均改良 Harris 髋关节评分提高到 88.8 分。术中股骨骨折发生了2例(33.3%)。在随访过程中,有1个骨干在术后6周至6个月期间发生了屈曲倾斜,但未出现下陷。除此之外,所有骨干在最近的随访中均显示骨结合良好。没有发生髋关节脱位、假体周围关节感染或假体松动:结论:对于股骨极度发育不良的患者,在全髋关节置换术中使用超小型股骨柄可提供合理的临床和放射学结果,并发症极少。我们认为,对于股骨极度发育不良的患者来说,这种股骨柄是一种可行的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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