Multilock 대퇴 스템을 이용한 무시멘트형 인공 고관절 전치환술 : 최소 5년 이상 추시 결과

Abstract

Purpose: This study evaluated the osteolysis of the femoral stem and acetabular cup, the frequency and cause of replacements in a minimum of a five year result of primary total hip arthroplasty with a non-cemented Multilock femoral stem from clinical and radiological results. Materials and Methods: The clinical and radiological results of forty-four total hip arthroplasty in forty patients that were available for follow up for a minimum of 5 years(average90.6 months) using a Multilock femoral stem and Harris-Galante II acetabular component performed between June 1993 and February 1997 were reviewed. Results: The average Harris hip score improved from 54.5 points preoperatively to 91.5 points postoperatively. The stability of the femoral stem based on the Engh's evaluation showed stable with osseous ingrowth in 43 cases(98%), stable with fibrous ingrowth in 1 case(2%), and no unstable fixation. Femoral osteolysis occurred in 17 cases(38%) which was mostly restricted to zoneⅠand Ⅶ. Acetabular osteolysis occurred in 9 cases(20.5%), with zone Ⅱ being the most common location. There were no cases of femoral stem revision. 7 cases of acetabular revision was done due to the defect of Harris-Galante II acetabular cup in 3 cases and osteolysis of a large area in 4 cases. The mean revision period was 73 months(37-112) from the initial operation. Conclusion: The femoral stem devised to press fit through circumferential proximal porous coating and flute type distal stem has the benefit of excellent fixation and prevention of distal bone canal wear particle invasion caused by proximal bone ingrowth. However, the frequency of revision was great due to the structural defect of Harris-Galante type II acetabular cup and the high occurrence of osteolysis.