■短柄假体最初是为年轻和更活跃的患者设计的。近年来,他们越来越多地提供给老年患者。这项研究评估了60岁以上患者植入无骨水泥短髋部后,短柄假体的中长期存活以及假体周围骨密度的变化。
■118名60岁以上的患者接受了短柄假体。临床检查包括Harris髋关节评分(HHS)和髋关节残疾和骨关节炎结果评分(HOOS)。对93例患者进行临床随访至少5年。53例患者接受了双能X线骨密度仪(DXA)和影像学评估。随访间隔为术前和术后(t0),在大约六个月(t1)时,在大约两年(t2),以及大约五年或更晚(t3)。
■在所有118名患者的平均6.7年观察期内,由于创伤性假体周围茎骨折,发生了一次茎翻修。在95名有风险的患者中,Metha®茎的终点生存率的五年生存率为99.2%。HHS从t0的55.3±11.5(范围30-79)显著改善到t3的95.3±8.6(范围57-100),平均8.0年(p<0.001)。HOOS在每个子量表中均有显著改善(p<0.001)。平均7.1年后,53例患者的骨矿物质密度(BMD)可供检查。感兴趣区域(ROI)3(+0.4%)和ROI6(+2.9%)的BMD从t0到t3增加,ROI1(-10.3%)下降,ROI2(-9.8%),ROI4(-5.3%),ROI5(-3.4%)和ROI7(-23.1%)。
■评估的短柄假体在老年患者中显示出极高的存活率,伴随着优异的临床效果。负荷转移测量显示,在观察到的时间段内,干骨干端-干骨干端转移有增加的趋势。
UNASSIGNED: Short stem prostheses were originally designed for younger and more active patients. In recent years, they have been increasingly offered to older patients. This study evaluates the mid-to long-term survival of a short stem prosthesis and the changes in periprosthetic bone density following implantation of a cementless short hip stem in patients over 60 years of age.
UNASSIGNED: 118 patients aged over 60 received short stem prostheses. Clinical examination included Harris Hip Score (HHS) and Hip Disability and Osteoarthritis Outcome Score (HOOS). 93 patients were followed clinically for at least five years. 53 patients underwent dual-energy x-ray absorptiometry (DXA) and radiographic evaluation. Follow-up intervals were preoperative and postoperative (t0), at approximately six months (t1), at approximately two years (t2), and at approximately five years or later (t3).
UNASSIGNED: Over a mean 6.7-year observation period for all 118 patients, one stem revision occurred due to a traumatic periprosthetic stem fracture. The five-year survival rate for the endpoint survival of the Metha® stem in 95 at-risk patients is 99.2%. HHS improved significantly from t0 55.3 ± 11.5 (range 30-79) to t3 95.3 ± 8.6 (range 57-100) at a mean of 8.0 years (p < 0.001). HOOS improved significantly in each subscale (p < 0.001). Bone mineral density (BMD) was available for review in 53 patients after a mean of 7.1 years. BMD increased from t0 to t3 in region of interest (ROI) 3 (+0.4%) and ROI 6 (+2.9%) and decreased in ROI 1 (-10.3%), ROI 2 (-9.8%), ROI 4 (-5.3%), ROI 5 (-3.4%) and ROI 7 (-23.1%).
UNASSIGNED: The evaluated short stem prosthesis shows a remarkably high survival rate in elderly patients, accompanied by excellent clinical results. Load transfer measurements show a metaphyseal-diaphyseal pattern with a trend towards increased diaphyseal transfer over the period observed.