用于初级全髋关节置换术的无骨水泥钛制扁平锥形短柄的早中期疗效:独立系列研究。

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-05-01 Epub Date: 2023-12-11 DOI:10.1177/11207000231216421
Jonathan Bourget-Murray, Brook Biniam, Raman S Bhullar, Paul Kim, Wade Gofton, Paul E Beaulé, George Grammatopoulos
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引用次数: 0

摘要

简介本研究旨在:(1) 描述使用无骨水泥、钛、扁平、锥形短柄进行初次全髋关节置换术(THA)的患者的围手术期并发症;(2) 估计该柄的早中期存活率;(3) 确定与翻修关节置换术相关的因素;(4) 描述术后至少 6 年的股骨重塑情况:方法:对使用Taperloc Microplasty柄(Zimmer-Biomet,Warsaw,Indiana,USA)接受THA手术且随访至少2年的连续患者进行回顾性研究。手术由2014年至2018年期间6名非设计师关节置换外科医生中的1人完成。结果包括围手术期并发症(包括翻修关节置换术)和存活率。Cox分析法用于分析不同因素对翻修关节置换术风险的影响。随访6年的X光片用于描述股骨重塑情况:对1205名患者进行了5.1 ± 1.4年的随访,围手术期并发症的发生率为5.2%,其中29名患者(2.4%)需要进行翻修关节置换术。5年和7年生存率分别为97.8%(95% CI,96.9-98.5)和97.0%(95% CI,95.6-98.0)。与翻修关节置换术相关的唯一因素是股骨近端形态,根据Dorr分类(HR 1.24 [95%CI, 1.09-1.41];P = 0.005)。在放射学评估中,12%的患者在格鲁恩3区或5区的皮质厚度相对变化⩾25%。我们在50%的X光片中观察到钙质重塑,而10%的X光片显示存在基底征:结论:Taperloc显微成形术柄的7年存活率符合国家健康与护理优化研究所(NICE)的指导方针。65岁以上患有骨关节炎且股骨形态为Dorr A/B的患者可能是使用该柄进行THA的理想人选。股骨重塑很常见,与不良预后无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early- to mid-term outcome of a short, cementless, titanium, flat, tapered stem for primary total hip arthroplasty: an independent series.

Introduction: This study aims to: (1) describe perioperative complications amongst patients who underwent primary total hip arthroplasty (THA) using a short cementless, titanium, flat, tapered stem; (2) estimate this stem's early- to mid-term survival; (3) identify factors associated with revision arthroplasty; and (4) describe femoral remodelling at minimum 6 years postoperatively.

Methods: A retrospective review of consecutive patients who underwent THA using a Taperloc Microplasty stem (Zimmer-Biomet, Warsaw, Indiana, USA) with minimum 2-year follow-up was performed. Surgeries were performed by 1 of 6, non-designer, arthroplasty surgeons between 2014 and 2018. Outcomes included perioperative complications including revision arthroplasty, and survival. Cox analysis was used to analyse the effect of different factors on risk of revision arthroplasty. Radiographs with 6-year follow-up served to describe femoral remodelling.

Results: In 1205 patients, followed for 5.1 ± 1.4 years, the incidence of perioperative complication was 5.2% for which 29 patients (2.4%) required revision arthroplasty. The 5- and 7-year survival rates were 97.8% (95% CI, 96.9-98.5) and 97.0% (95% CI, 95.6-98.0), respectively. The only factor associated with revision arthroplasty was proximal femur morphology, as per Dorr classification (HR 1.24 [95%CI, 1.09-1.41]; p = 0.005). During radiographic assessment, 12% of patients showed ⩾25% of relative change in cortical thickness in Gruen zones 3 or 5. We observed calcar remodelling in 50% of radiographs while 10% showed presence of a pedestal sign.

Conclusions: The 7-year survivorship of the Taperloc Microplasty stem is within National Institute for Health and Care Excellence (NICE) guidelines. Patients ⩽65 years with osteoarthritis and Dorr A/B femoral morphology may be ideal candidates for THA with this stem. Femoral remodelling is common and not associated with adverse outcome.

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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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