Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Total Hip Arthroplasty Using a Large Femoral Head : The Short-Term Follow-up Results and the Early Complications

큰 대퇴 골두를 사용한 인공 고관절 전치환술 : 초기 합병증에 관한 단기 추시 결과

  • Cho, Myung-Rae (Department of Orthopaedic Surgery, School of Medicine, Catholic University) ;
  • Kim, Se-Sik (Department of Orthopaedic Surgery, School of Medicine, Catholic University) ;
  • Lee, Hyun-Seop (Department of Orthopaedic Surgery, School of Medicine, Catholic University)
  • 조명래 (대구가톨릭대학교 정형외과학교실) ;
  • 김세식 (대구가톨릭대학교 정형외과학교실) ;
  • 이현섭 (대구가톨릭대학교 정형외과학교실)
  • Published : 2009.09.30

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Abstract

Purpose: This study evaluated the short-term follow-up results after total hip arthroplasty with using a 36 mm large femoral head. Materials and Methods: Between August 2004 and August 2007, 104 patients were treated with total hip arthroplasties using a 36 mm-Cobalt-Chrome femoral head with Longevity (Zimmer, Warsaw, IN) as the polyethylene liner. The average age at the time of the index operation was 61.4 years (range: 23 to 87 years), and the mean follow-up period was 27 months (range: 18 to 46 months). The clinical results and early complications after the operation were analyzed. Results: The Harris Hip Scores were more than 'Good' in all cases with an average score of 93, and the Merle d' Aubigne and Postel scores were more than 'Good' in 75% of the patients. All the femoral stems that were cemented or cementless had satisfactory fixation. Dislocation developed in one case and only one time, and there were no other complications during the follow-up period Conclusion: Total hip arthroplasty with using a 36 mm large femoral head is a recommendable treatment with a low dislocation rate and high satisfaction, which comes from the lack of restriction of the postoperative hip position and movement.

목적: 36 mm 대퇴 골두를 사용한 인공 고관절 전치환술 후 초기 추시 결과를 알아보고자 한다. 대상 및 방법: 2004년 8월에서 2007년 8월까지 $Longevity^{(R)}$ ($Zimmer^{(R)}$, Warsaw, IN, USA) 폴리 에틸렌과 36 mm Cobalt-Chrome 대퇴 골두를 사용하여 인공 고관절 전치환술을 시행한 104례를 대상으로 하였다. 수술 당시 평균 연령은 61.4세(28~87), 평균 추시 기간은 27개월(18~46)이었다. 임상적 평가와 술 후 발생 가능한 초기 합병증에 대하여 관찰하였다. 결과: Harris Hip Score는 전 예에서 양호 이상으로, 평균 93점이었다. Merle d'Aubigne and Postel score도 75%에서 양호 이상을 보였다. 무시멘트 및 시멘트성 대퇴 부품 전 예에서 수술 후 방사선 사진상 만족할 만한 고정을 보였다. 1예에서 1회의 탈구가 관찰되었으며 추시 기간 동안 다른 합병증은 발생하지 않았다. 결론: 큰 대퇴 골두를 이용한 인공 고관절 전치환술 후 환자의 고관절 자세나 운동에 제한을 두지 않아 환자의 만족도가 높았고 탈구의 빈도도 낮아 권장할 만한 수술 방법이라 판단된다.

Keywords

References

  1. Barrack RL, Mulroy RD, Jr., Harris WH. Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review. J Bone Joint Surg, 74-B: 385-389, 1992.
  2. Berry DJ. Unstable total hip arthroplasty: detailed overview. Instr Course Lect, 50: 265-274, 2001.
  3. Burroughs BR, Hallstrom B, Golladay GJ, Hoeffel D, Harris WH.: Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes. J Arthroplasty, 20: 11-19, 2005. https://doi.org/10.1016/j.arth.2004.07.008
  4. Burroughs BR, Rubash HE, Harris WH. Femoral head sizes larger than 32 mm against highly cross-linked polyethylene. Clin Orthop Relat Res, 405: 150-157, 2002. https://doi.org/10.1097/00003086-200212000-00018
  5. Chandler DR, Glousman R, Hull D, et al. Prosthetic hip range of motion and impingement. The effects of head and neck geometry. Clin Orthop, 166: 284-291, 1982.
  6. Charnley J. Total hip replacement by low-friction arthroplasty. Clin Orthop, 72: 7-21, 1970.
  7. d'Aubigne R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J bone Joint Surg, 36- A: 451-457, 1954.
  8. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br, 69-B: 45-55, 1987.
  9. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg, 51-A: 737-755, 1969.
  10. Harris WH, Muratoglu OK. A review of current crosslinked polyethylenes used in total joint arthroplasty. Clin Orthop, 430: 46-52, 2005.
  11. Kabo JM, Gebhard JS, Loren G, Amstutz HC. In vivo wear of polyethylene acetabular components. J Bone Joint Surg, 75-B: 254-258, 1993.
  12. Lee PC, Shih CH, Chen WJ, Tu YK, Tai CL. Early polyethylene wear and osteolysis in cementless total hip arthroplasty: the influence of femoral head size and polyethylene thickness. J Arthroplasty, 14: 976-981, 1999. https://doi.org/10.1016/S0883-5403(99)90013-X
  13. Livermore J, Ilstrup D, Morrey B. Effect of femoral head size on wear of the polyethylene acetabular component. J Bone Joint Surg, 72-A: 518-528, 1990.
  14. Mai MT, Schmalzried TP, Dorey FJ, Campbell PA, Amstutz HC. The contribution of frictional torque to loosening at the cement-bone interface in Tharies hip replacements. J Bone Joint Surg, 78-A: 505-511, 1996.
  15. Manning DW, Chiang PP, Martell JM, Galante JO, Harris WH. In vivo comparative wear study of traditional and highly cross-linked polyethylene in total hip arthroplasty. J Arthroplasty, 20: 880-886, 2005. https://doi.org/10.1016/j.arth.2005.03.033
  16. Morrey BF. Instability after total hip arthroplasty. Orthop Clin North Am, 23: 237-248, 1992.
  17. Morrey BF, Ilstrup D. Size of the femoral head and acetabular revision in total hip-replacement arthroplasty. J Bone Joint Surg, 71-A: 50-55, 1989.
  18. Muratoglu OK, Greenbaum ES, Bragdon CR, Jasty M, Freiberg AA, Harris WH. Surface analysis of early retrieved acetabular polyethylene liners: a comparison of conventional and highly crosslinked polyethylenes. J Arthroplasty, 19: 68-77, 2004. https://doi.org/10.1016/j.arth.2003.08.003
  19. Scifert CF, Brown TD, Lipman JD. Finite element analysis of a novel design approach to resisting total hip dislocation. Clin Biomech (Bristol, Avon), 14: 697-703, 1999. https://doi.org/10.1016/S0268-0033(99)00054-6
  20. Turner RS. Postoperative total hip prosthetic femoral head dislocations. Incidence, etiologic factors, and management. Clin Orthop, 301: 196-204, 1994.
  21. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg, 64-A: 1295-1306, 1982.
  22. Yamaguchi M, Akisue T, Bauer TW, Hashimoto Y. The spatial location of impingement in total hip arthroplasty. J Arthroplasty, 15: 305-313, 2000. https://doi.org/10.1016/S0883-5403(00)90601-6