New Cementless Total Hip Arthroplasty. A Multicentre Prospective Minimum 2 Year Follow-up Clinical Outcomes Study.

Rohit Pandey, S. Coffey, R. Sorial
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Abstract

Background: Cementless implants were introduced approximately three decades ago in order to address aseptic loosening of cemented hip prostheses with the aim of early mobilisation, better functional result and bone stock preservation. The primary objective of this study is to introduce a new cementless HA coated implant and report its minimum 2 year follow up results. Material & method: This is a prospective, multi-centre, consecutive series, clinical outcomes study with 75 patients. Inclusion criteria for the study were age 21- 85 years, BMI <40, osteoarthritis of the hip. Patients were operated using a standard posterolateral approach. The Paragon stem and the Global cup were implanted in a cementless method. Patients were reviewed at 6 weeks, 6 months and two years postoperative. At each visit AQoL 6D, VAS Pain, Oxford Hip Score were recorded. Post-operative X-Rays were reviewed at immediate post-operative, 6 months and two years. Results: Mean duration of surgery was 63.1 min with range of 40-120 min. AQoL over time changed from pre-op mean 50.51, at 6 weeks and at 2 years mean 35.06. Oxford hip score had upward trend from pre-op to post-op 6wks assessments and a plateau in following assessments. VAS pain trajectories, showing a clear downward trend from pre-op to post-op 6wks and a plateau in the following postoperative assessments. Discussion & conclusion: The combination of Paragon stem and Global cup incorporates proven features of successful implants. The unique feature of lateral tension grooves and progressive neck dimension with dual offset options. This combination has shown promising early results with early follow up of a minimum of 2 years, with a 100% survivorship of the stem and 98.7% survivorship overall for any reason and is a good cementless option in THA.
新型无骨水泥全髋关节置换术。一项多中心前瞻性至少2年随访临床结果研究。
背景:大约三十年前,为了解决骨水泥髋关节假体的无菌性松动问题,引入了无骨水泥植入物,目的是早期动员、更好的功能结果和骨储备保存。本研究的主要目的是介绍一种新型无骨水泥HA涂层植入物,并报告其至少2年的随访结果。材料和方法:这是一项前瞻性、多中心、连续系列的临床结果研究,共有75名患者。该研究的纳入标准为年龄21-85岁,BMI<40,髋关节骨性关节炎。患者采用标准后外侧入路进行手术。Paragon干和Global cup采用非骨水泥方法植入。在术后6周、6个月和2年对患者进行复查。每次就诊时记录AQoL 6D、VAS疼痛、Oxford髋关节评分。术后X光检查在术后即刻、6个月和两年进行。结果:手术的平均持续时间为63.1分钟,范围为40-120分钟。随着时间的推移,AQoL从术前的平均值50.51、6周和2年的平均值35.06变化。从术前到术后6周的评估,牛津髋关节评分呈上升趋势,随后的评估呈平稳状态。VAS疼痛轨迹,从术前到术后6周显示出明显的下降趋势,在随后的术后评估中呈平稳状态。讨论和结论:Paragon干细胞和Global cup的结合结合了成功植入的公认特征。独特的横向张力凹槽和渐进式颈部尺寸,可选择双偏置。该组合已显示出有希望的早期结果,早期随访至少2年,干细胞存活率为100%,无论出于何种原因,总存活率为98.7%,是THA的一个良好的非骨水泥选择。
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