SHORT TERM COMPARISON OF CLINIC RADIOGRAPHIC RESULTS OF TOTAL HIP REPLACEMENT WITH SHORT FEMORAL STEM IN OBESE AND NON-OBESE YOUNG PATIENTS. SINGLE CENTER PROSPECTIVE PILOT STUDY.

Q4 Medicine
Georgian medical news Pub Date : 2024-11-01
D Godoy-Monzon, P Telesca, J Espinosa
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Abstract

Background: Total hip arthroplasty (THA) is a highly successful orthopedic procedure increasingly performed on younger, obese patients due to its ability to improve functional outcomes and quality of life. However, obesity presents challenges related to implant selection and long-term outcomes, particularly with the use of short femoral stems. While short stems offer benefits such as bone preservation and reduced stress shielding, their reliability in obese patients remains underreported.

Aim: Compare functional and radiographic results of THA in obese versus non obese young patients.

Methods: This single-center case-control study evaluated clinical and radiographic outcomes of obese patients (BMI ≥30 kg/m²) undergoing primary uncemented THA with short femoral stems. A total of 120 patients (60 obese, 60 nonobese) were enrolled, matched 1:1. Outcomes assessed included surgical parameters, Harris Hip Score (HHS), Roles and Maudsley satisfaction score, and radiographic implant evaluations at a minimum follow-up of two years. Statistical comparisons were performed using SPSS, with a significant threshold of p<0.05.

Results: Operative times and incision lengths were modestly longer in obese patients (p<0.05). Mean postoperative HHS improved significantly in both groups, with scores of 91±3.7 (obese) and 93±2.5 (nonobese). Radiographic analysis showed excellent implant positioning, with all components within the Lewinnek safe zone. Minor radiolucencies and subsidence (≤2 mm) were observed in a small subset of obese patients but were clinically insignificant. Complication rates were low and comparable between groups, with one superficial infection in the obese group and one deep venous thrombosis in the nonobese group.

Conclusions: Short femoral stems in uncemented THA demonstrate safe and effective performance in obese patients, yielding clinical and radiographic outcomes comparable to nonobese patients. Short stems provide the added advantage of bone preservation, which is critical for revision surgery in younger, obese populations. Larger studies with longer follow-up are needed to validate these findings and assess long-term implant survival.

肥胖与非肥胖青年短股骨干全髋关节置换术的近期临床影像学结果比较。单中心前瞻性先导研究。
背景:全髋关节置换术(THA)是一种非常成功的骨科手术,越来越多地用于年轻肥胖患者,因为它能够改善功能结局和生活质量。然而,肥胖带来了与植入物选择和长期结果相关的挑战,特别是使用短股骨干。虽然短茎提供了诸如骨骼保护和减少应力屏蔽等好处,但它们在肥胖患者中的可靠性仍未得到充分报道。目的:比较肥胖和非肥胖青年患者全髋关节置换术的功能和影像学结果。方法:本单中心病例对照研究评估肥胖患者(BMI≥30 kg/m²)接受短股骨干一期非骨水泥THA的临床和影像学结果。共纳入120例患者(肥胖60例,非肥胖60例),比例为1:1。评估的结果包括手术参数、Harris髋关节评分(HHS)、Roles和Maudsley满意度评分,以及至少随访两年的放射学植入物评估。使用SPSS进行统计比较,结果具有显著的阈值:肥胖患者的手术时间和切口长度略长(结论:非骨水泥THA中的短股骨干在肥胖患者中表现出安全有效的性能,其临床和影像学结果与非肥胖患者相当。短茎提供了骨骼保存的额外优势,这对于年轻肥胖人群的翻修手术至关重要。需要更大规模的随访研究来验证这些发现并评估种植体的长期存活。
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
Georgian medical news
Georgian medical news Medicine-Medicine (all)
CiteScore
0.60
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发文量
207
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