Weak hammering sounds are associated with postoperative subsidence in cementless total hip arthroplasty.

IF 2 3区医学 Q2 ORTHOPEDICS

International Orthopaedics Pub Date : 2025-02-01 Epub Date: 2024-10-18 DOI:10.1007/s00264-024-06351-w

Yasuhiro Homma, Ken Tashiro, Ryuji Okuno, Masashi Unoki, Yuki Murakami, Taiji Watari, Tomonori Baba, Muneaki Ishijima

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引用次数: 0

Abstract

Purpose: The aim of this study was to investigate the relationship between the hammering sound level and the presence of postoperative subsidence.

Methods: The last five hammering sounds during the final-size broaching procedure and during the real stem insertion were recorded and analysed in 95 patients who were operated on by one of seven surgeons using two implants (Trident cup, Accolade II, Stryker; G7 cup, Taperloc Complete Microplasty Stem, Zimmer Biomet). The maximum peak was semi-automatically identified and analysed to determine the maximum C-weighted sound pressure level (LCpeak) of each of the five hammering sounds and the equivalent continuous A-weighted sound pressure (LAeq) of the entire five-sound hammering procedure.

Results: Among the 95 hips, 25 (26.3%) had ≥ 3 mm of postoperative subsidence. Therefore, 125 of 475 hammering sounds (LCpeak) and 25 of 95 hammering procedures (LAeq) in both the broaching procedure and stem insertion procedure were associated with postoperative subsidence. The hammering sound level in both the broaching and stem insertion procedures were significantly weaker in patients with postoperative subsidence than in those without subsidence. Among the seven surgeons, there was intra-surgeon and inter-surgeon heterogeneity with large variance regarding the sound levels. With univariate and multivariate analyses, the hammering sound level was independently associated with postoperative subsidence in the two models.

Conclusion: A weak hammering sound level was associated with postoperative subsidence in THA with a cementless stem. An objective evaluation of the hammering procedure might be useful to decrease the incidence of postoperative subsidence.

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无骨水泥全髋关节置换术的术后下沉与微弱的锤击声有关。

目的：本研究旨在探讨锤击声水平与术后下沉之间的关系：记录并分析了由七名外科医生之一使用两种植入物（史赛克公司的Trident杯、Accolade II；Zimmer Biomet公司的G7杯、Taperloc完全显微成形术柄）对95名患者进行最终尺寸拉床手术和真正插入柄时的最后五次锤击声。对最大峰值进行半自动识别和分析，以确定五声锤击声中每一声的最大 C 加权声压级（LCpeak）和整个五声锤击过程的等效连续 A 加权声压级（LAeq）：在 95 个髋关节中，有 25 个（26.3%）术后下沉≥ 3 毫米。因此，在475次锤击声中有125次（LCpeak），在95次锤击过程中有25次（LAeq）与术后下陷有关。术后出现下陷的患者在拉削手术和柄插入手术中的锤击声水平明显弱于未出现下陷的患者。在七名外科医生中，医生内部和医生之间的声级差异很大。通过单变量和多变量分析，在两个模型中，锤击声级与术后下沉独立相关：结论：在使用无骨水泥柄的全人工关节置换术中，较弱的锤击声级与术后下沉有关。对锤击过程进行客观评估可能有助于降低术后下沉的发生率。

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

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.