全无骨水泥人工髋关节置换术与短柄假体的早期疗效。

Q3 Medicine
Rafał Skowroński, Tomasz Stołtny, Jan Skowroński
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引用次数: 0

摘要

背景:所谓的短柄髋关节内假体植入物数量的稳步增加促使新模型被引入市场的临床评估。本研究的目的是评估新的Medgal-HIp短茎内假体的临床和放射学早期结果和经验。材料和方法:本前瞻性研究纳入121例患者,平均年龄65.2岁(42-87岁),接受短柄Medgal-HIp无骨水泥假体植入。术前、术后6周、6个月、1年、2年分别进行临床和影像学评价。用HHS量表和疼痛评分(VAS)评估功能结局。影像学检查评估骨溶解灶、放射不透明线、骨化和轴干迁移以及肢体长度差异的存在。结果:功能检查显示术后2年HHS平均评分从39.1分(范围34-56分)增加到88.9分。(范围59-100),p=0.041。平均VAS疼痛评分在2年后从8.7降至0.81 (p=0.012)。所有患者均无感染、大腿疼痛或关节周围骨折。x线片未见植体周围骨溶解灶或放射性不透明线。2例患者出现轻度无症状骨化(Brooker 1级)。在每个病例中,在术后6个月至2年期间,通过骨整合实现了骨干愈合。茎的平均轴向偏移量为1.6 mm(标准差为1.79 mm,范围为0 ~ 6mm), p <0.05。肢长差的平均值为6.5 mm (SD为6.7 mm,范围为-11 mm至+12 mm), p= 0.23。2例需要髋臼翻修手术。根据Kaplan-Meier法,假体2年后的成活率为98.3%,单柄成活率为100%。Medgal-HIp短柄内假体的这些早期临床结果与其他市售短柄内假体的数据相当。2. 放射学分析结果和临床结果表明,假体内支架发生大腿疼痛、假体周围骨折或支架过度移动的风险很小。3. 由于随访时间短,当远期结果可用时,可以对种植体进行权威评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early Outcomes of Total Cementless Hip Joint Arthroplasty with Short-Stem Prothesis.

Background: The steady increase in the number of implants of so-called short-stem hip endoprostheses has prompted clinical evaluation of new models being introduced to the market. The purpose of this study was to evaluate the clinical and radiological early results and experience of the new Medgal-HIp short-stem endoprosthesis implant.

Material and methods: This prospective study involved 121 patients at a mean age of 65.2 years (range 42-87) who underwent implantation of a short-stem Medgal-HIp cementless prosthesis. Clinical and radiological evaluations were performed the day before surgery and at 6 weeks, 6 months, 1 year and 2 years after surgery. Functional outcomes were assessed with the HHS scale and pain, with a VAS scale. Radiological examinations evaluated the presence of osteolytic foci, radio-opaque lines, ossifications and axial stem migration as well as limb length difference.

Results: Functional tests showed an increase in mean HHS scores at 2 years post-surgery from 39.1 points (range 34-56) to 88.9 points. (range 59-100) at p=0.041. The mean VAS pain score had decreased at 2 years from a value of 8.7 to 0.81 at p=0.012. No infections, thigh pain or periarticular fractures were noted in any patient. No foci of osteolysis or radio-opaque lines around the implant were noted on radiographs. Minor asymptomatic ossification (Brooker grade 1) appeared in 2 patients. In each case, stem healing occurred through osteointegration between 6 months and 2 years post-surgery. Mean axial migration of the stem was 1.6 mm (SD 1.79 mm and range from 0 to 6mm) at p <0.05. Limb length difference reached a mean value of 6.5 mm (SD 6.7 mm with a range from -11 mm to +12 mm) at p= 0.23. Two cases required revision surgeries related to the acetabulum. Survival of the prosthesis after 2 years according to Kaplan-Meier was 98.3% and that of the stem alone was 100%Conclusions 1. These early clinical results of the Medgal-HIp short-stem endoprosthesis are comparable to data regarding other commercially available short-stem implants. 2. The results of radiological analysis together with clinical results suggest that the stem of the endoprosthesis carries minimal risk of thigh pain, peri-prosthesis fracture or excessive stem migration. 3. Due to the short follow-up period, an authoritative evaluation of the implant will be possible when the distant outcomes are available.

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来源期刊
Ortopedia, traumatologia, rehabilitacja
Ortopedia, traumatologia, rehabilitacja Medicine-Rehabilitation
CiteScore
1.00
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