Hip & pelvis

The Korean Hip Society (대한고관절학회)
권호 표지

Cemented Total Hip Replacement Arthroplasty

시멘트 인공 고관절 전치환술

  • Yim, Soo-Jae (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University) ;
  • Lee, Sang-Hyuk (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University) ;
  • Kim, Myoung-Hoe (Department of Orthopaedic Surgery, College of Medicine, Soonchunhyang University)
  • 임수재 (순천향대학교 의과대학 정형외과학교실) ;
  • 이상혁 (순천향대학교 의과대학 정형외과학교실) ;
  • 김명회 (순천향대학교 의과대학 정형외과학교실)
  • Published : 2010.06.30
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Abstract

The use of cement in total hip replacement arthroplasty has long controversial. However, since the 1980s, osteolysis has occurred with high frequency in cementless total hip replacement arthroplasty, and has been a significant cause for loosening. Recently, a cemented femoral stem has been frequently used because of improvements in cement techniques, materials for joint arthroplasty, design, etc. Also, the use of an acetabular cup with cement seems desirable where indications are for a revision procedure or where there is an aged patient with severe osteoporosis, and where the patient requires a broad bone graft due to an acetabular bone defect. The purpose of this article was (i) to review how to fix an acetabular cup with cement and a femoral stem in current hip replacement arthroplasty procedures and (ii) to review possible directions for further development.

인공 고관절 전치환술에서 시멘트의 사용여부는 과거부터 많은 논란이 되고 있다. 하지만 1980년대에 무시멘트 인공 고관절 전치환술에서 골용해가 높은 빈도로 발생하여 해리의 중요한 원인으로 발생하였고 시멘트 기법 및 인공 관절의 재질, 디자인 등의 개선으로 인하여 최근에 시멘트형의 대퇴 주대의 사용이 빈번해 지기 시작하였다. 또한 비구측의 시멘트 사용에 대해서도 재치환술이나, 골 다공증이 심한 노령의 환자, 비구의 결손이 있어서 광범위한 골 이식이 필요한 환자 등의 적절한 적응증의 경우 시멘트를 이용한 비구컵의 사용이 바람직할 것으로 보인다. 본 논문의 목적은 현재 인공 고관절 치환술에서 시멘트를 이용한 비구컵과 대퇴스템의 고정방법에 대하여 살펴보고 앞으로 발전 방향에 관하여 알아보고자 한다.

Keywords

References

  1. Eftekhar NS, Pawluk RJ. Role of surgical preparation in acetabular cup fixation. In: The Hip, Proceedings of the eighth open scientific meeting of the Hip Society pp. St. Louis: C. V. Mosby;1980. 308-28.
  2. Carter DR, Vasu R, Harris WH. Periacetabular stress distributions after joint replacement with subchondral bone retention. Acta Orthop Scand. 1983;54:29-35.
  3. Harrington MA Jr. O'Connor DO, Lozynsky AJ, Kovach I, Harris WH. Effects of femoral neck length, stem size, and body weight on strains in the proximal cement mantle. J Bone Joint Surg Am. 2002;84-A:573-9.
  4. Ling RS, Lee AJ. Porosity reduction in acrylic cement is clinically irrelevant. Clin Orthop Relat Res. 1998;355:249-53. https://doi.org/10.1097/00003086-199810000-00026
  5. Ko HS. Polyethylene bone cement acetabular cup. J Korean Hip Soc. 1999;11:1-6.
  6. Schulte KR, Callaghan JJ, Kelley SS, Johnston RC. The outcome of Charnley total hip arthroplasty with cement after a minimum twenty-year follow-up. The results of one surgeon. J Bone Joint Surg Am. 1993;75:961-75.
  7. Neumann L, Freund KG, Sorensen KH. Total hip arthroplasty with the Charnley prosthesis in patients fiftyfive years old and less. Fifteen to twenty-one-year results. J Bone Joint Surg Am. 1996;78:73-9.
  8. Ranawat CS, Deshmukh RG, Peters LE, Umlas ME. Prediction of the long-term durability of all-polyethylene cemented sockets. Clin Orthop Relat Res. 1995;317:89-105.
  9. Ranawat CS, Peters LE, Umlas ME. Fixation of the acetabular component. The case for cement. Clin Orthop Relat Res. 1997;344:207-15.
  10. Barrack RL. Early failure of modern cemented stems. J Arthroplasty. 2000;15:1036-50. https://doi.org/10.1054/arth.2000.16498
  11. 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. 1992;74B:385-9.
  12. Creighton MG, Callaghan JJ, Olejniczak JP, Johnston RC. Total hip arthroplasty with cement in patients who have rheumatoid arthritis. A minimum ten-year follow-up study. J Bone Joint Surg Am. 1998;80:1439-46.
  13. Goldberg BA, al-Habbal G, Noble PC, Paravic M, Liebs TR, Tullos HS. Proximal and distal femoral centralizers in modern cemented hip arthroplasty. Clin Orthop Relat Res. 1998;349:163-73. https://doi.org/10.1097/00003086-199804000-00020
  14. Kelly SS, Fitzgerald RH Jr, Rand JA, Ilstrup DM. A prospective randomized study of a collared versus a collarless femoral component. Prosthesis. Clin Orthop Relat Res. 1993;294:114-22.
  15. Meding JB, Ritter MA, Keating EM, Faris PM. Comparison of collared and collarless femoral components in primary uncemented total hip arthroplasty. J Arthroplasty. 1997;12:273-80. https://doi.org/10.1016/S0883-5403(97)90023-1
  16. Rickards R, Duncan CP. The collar-calcar contact controversy. J Bone Joint Surg Br. 1986;68:851.
  17. Park JB, von Recum AF, Gratzick GE. Pre-coated orthopedic implants with bone cement. Biomater Med Devices Artif Organs. 1979;7:41-53.
  18. Raab S, Ahmed AM, Provan JW. The quasistatic and fatigue performance of the implant/bone-cement interface. J Biomed Mater Res. 1981;15:159-82. https://doi.org/10.1002/jbm.820150205
  19. Raab S, Ahmed AM, Provan JW. Thin film PMMA precoating for improved implant bone-cement fixation. J Biomed Mater Res. 1982;16:679-704. https://doi.org/10.1002/jbm.820160515
  20. Harris WH. Is it advantageous to strengthen the cementmetal interface and use a collar for cemented femoral components of total hip replacements? Clin Orthop Relat Res. 1992;285:67-72.
  21. Fowler JL, Gie GA, Lee AJ, Ling RS. Experience with the Exeter total hip replacement since 1970. Orthop Clin North Am. 1988;19:477-89.
  22. Ling RS. The use of a collar and precoating on cemented femoral stems is unnecessary and detrimental. Clin Orthop Relat Res. 1992;285:73-83.
  23. Herberts P, Malchau H. How outcome studies have changed total hip arthroplasty practices in Sweden. Clin Orthop Relat Res. 1997;344:44-60.
  24. Rasquinha VJ, Ranawat CS. Durability of the cemented femoral stem in patients 60 to 80 years old. Clin Orthop Relat Res. 2004;419:115-23. https://doi.org/10.1097/00003086-200402000-00019