Hip & pelvis

The Korean Hip Society (대한고관절학회)
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Ceramic-on-Ceramic Bearing Total Hip Arthroplasty: Five-Year Midterm Follow-up Results

세라믹-세라믹 관절면을 이용한 고관절 전치환술: 5년 중기 추시결과

  • Yim, Soo-Jae (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Jang, Mun-Suk (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Yoon, Joon-Hee (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Lee, Sang-Hyok (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital) ;
  • Kang, Hee-Kyung (Department of Orthopedic Surgery, Soonchunhyang University Bucheon Hospital)
  • 임수재 (순천향대학교 의과대학 부천병원 정형외과) ;
  • 장문석 (순천향대학교 의과대학 부천병원 정형외과) ;
  • 윤준희 (순천향대학교 의과대학 부천병원 정형외과) ;
  • 이상혁 (순천향대학교 의과대학 부천병원 정형외과) ;
  • 강희경 (순천향대학교 의과대학 부천병원 정형외과)
  • Published : 2011.12.31
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Abstract

Purpose: We believe that cemented femoral stems will relieve the stiffness of ceramic-based bearings, resulting in reduced complication of ceramic-on-ceramic bearing total hip arthroplasty (THA). The purpose of this study was to evaluate the midterm effect of ceramic-on-ceramic bearing THA using cemented femoral stems. Materials and Methods: We studied 32cases (30 patients) of THA using ceramic-on-ceramic bearing cemented femoral stems and 33 cases (31 patients) of THA using ceramic-on-ceramic bearing cementless femoral stems. All total hip arthroplasties were performed between January 2004 and December 2005 and were followed up for more than 5 years. The clinical results and radiographic results were evaluated. Results: The mean HHS improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). The mean WOMAC score also improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). But no statistically significant difference was noted between the cemented and cementless stem groups in HHS and WOMAC scores (P=0.304, P=0.769). There were 3 patients with a sense of discomfort on ambulation and 5 patients with thigh pain in the cementless stem group and no cases in the cemented stem group. There was no instance of acetabular loosening in either group. Subsidenc of the cemented femoral stem was less than 1mm in 30 cases and less than 2 mm in 2 cases. All cementless femoral stems acquired firm bony union. Conclusion: Midterm results showed no statistical links between ceramicon-ceramic-bearing THA using cemented femoral stems or cementless femoral stems.

목적: 세라믹에서 나타나는 강성 성질을 완화하여 세라믹-세라믹 관절면에서 나타나는 합병증을 시멘트형 대퇴 스템을 사용함으로써 감소 시킬 수 있을 것으로 생각하여 중기 추시의 효과를 알아보고자 하였다. 대상 및 방법: 2004년 1월부터 2005년 12월까지 시멘트형, 무 시멘트형 고관절 전치환술을 시행하고 5년 이상 추시 가능하였던 각각 30명 32예와 31명 33예를 대상으로 임상적 평가와 방사선학적 평가를 시행하였다. 결과: Harris 점수와 WOMAC 점수는 시멘트형 군과 무 시멘트형 군에서 수술 전 보다 최종 추시상 모두 향상되었다(P<0.05). 그러나 Harris 점수나 WOMAC 점수의 시멘트형과 무 시멘트형 간의 증가에 대한 특이한 차이는 없었다(P=0.304, P=0.769). 무 시멘트형 군에서만 보행 시 발생한 고관절부 불편감 3예, 대퇴부 통증 5예가 있었다. 양군에서 비구 컵의 골성 고정을 얻었고, 삽입물의 이동소견은 보이지 않았다. 시멘트형 군에서 대퇴 스템의 침강은 30예서 1 mm이내, 2예에서 2 mm 이내였으며, 무 시멘트형 군의 모든 예에서 대퇴 스템의 골성 고정을 얻었다. 결론: 세라믹-세라믹 관절면을 이용한 무 시멘트형과 시멘트형 고관절 전치환술의 중기 추시 결과는 통계학적으로 효과를 얻을 수 없었다.

Keywords

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