샌드위치 타입의 세라믹-세라믹 관절면을 이용한 일차성 무시멘트 고관절 전치환술 (최소 10년 추시 결과) = Primary Cementless Total Hip Arthroplasty with a Sandwich Type in Ceramic-Ceramic Articulation (Minimum 10-Year Follow up Results)

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the minimum 10-year follow up results of primary total hip arthroplasty (THA) performed using a sandwich-type (alumina-polyethylene-titanium) ceramic bearing. Materials and Methods: Thirty four patients (40 hips) who underwent a THA with sandwich typed liners from November 1998 to December 2000 were analyzed. Among the 34 patients, 25 were men and nine were women. Mean follow-up was 134 months (range, 120~145 months) and mean patient age at the time of THA was 47.1 years (range, 24~65 years). The clinical results were evaluated using the Harris hip score and level of thigh pain with a limping gait. The radiographic evaluation was done in terms of the endosteal new bone formation, radiolucent line, subsidence of the stem, migration of the acetabular cup, and proof of loosening. Results: The mean preoperative Harris hip score of 50.2 points (range, 31~87 points) was improved to 90.9 points (range, 75~99 points) at the final follow-up and thigh pain with limping gait in one case. All cases had fixation by bony ingrowth. No radiographically detectable loosening was observed in any hip. Fracture of ceramic liner in one case required change of the polyethylene liner. Conclusion: At the minimum 10-year follow up, survival rate as the end-point was favorable. However, fracture of the ceramic is still a major problem. Satisfactory results can be obtained by more precise surgical technique for acerabular inclincation and anteversion, and by improving the quality of the ceramic.

참고문헌 (Reference)

• 1 Berry DJ, "Unstable total hip arthroplasty: detailed overview" 50 : 265-274, 2001
• 2 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" 51 : 737-755, 1969
• 3 Hannouche D, "Thirty years of experience with alumina-on-alumina bearings in total hip arthroplasty" 35 : 207-213, 2011
• 4 Callaghan JJ, "The uncemented porous-coated anatomic total hip prosthesis. Two-year results of a prospective consecutive series" 70 : 337-346, 1988
• 5 Heekin RD, "The porous-coated anatomic total hip prosthesis, inserted without cement. Results after five to seven years in a prospective study" 75 : 77-91, 1993
• 6 Kawamura H, "The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty" 83 : 1333-1338, 2001
• 7 Nizard RS, "Ten-year survivorship of cemented ceramicceramic total hip prosthesis" 282 : 53-63, 1992
• 8 Park YS, "Ten-year results after cementless THA with a sandwich-type alumina ceramic bearing" 33 : 796-, 2010
• 9 Dalla PP, "Stiffness of the acetabular cups: a comparative study using the finite element method" 136-138, 1997
• 10 Engh CA, "Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components" 257 : 107-128, 1990
• 11 Bader R, "Range of motion vs position and design" Stuttgard, New York: Thieme Verlag 66-74, 2000
• 12 DeLee JG, "Radiological demarcation of cemented sockets in total hip replacement" 121 : 20-32, 1976
• 13 Bizot P, "Pressfit metal-backed alumina sockets: a minimum 5-year followup study" 379 : 134-142, 2000
• 14 Engh CA, "Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results" 69 : 45-55, 1987
• 15 Garbuz DS, "Periprosthetic fractures of the femur: principles of prevention and management" 47 : 237-242, 1998
• 16 D’Antonio J, "New experience with alumina-on-alumina ceramic bearings for total hip arthroplasty" 17 : 390-397, 2002
• 17 Gruen TA, "Modes of failure of cemented stem-type femoral components: a radiographic analysis of loosening" 141 : 17-27, 1979
• 18 Garcia-Cimbrelo E, "Mittelmeier ceramic-ceramic prosthesis after 10 years" 11 : 773-781, 1996
• 19 Nishii T, "Influence of component positions on dislocation: computed tomographic evaluations in a consecutive series of total hip arthroplasty" 19 : 162-166, 2004
• 20 Duncan CP, "Fractures of the femur after hip replacement" 44 : 293-304, 1995
• 21 Hwang SK, "Fracture-dissociation of ceramic liner" 31 : 804-, 2008
• 22 Suzuki K, "Fracture of a ceramic acetabular insert after ceramicon-ceramic THA--a case report" 74 : 101-103, 2003
• 23 Ravasi F, "Five-year follow-up with a ceramic sandwich cup in total hip replacement" 122 : 350-353, 2002
• 24 Livermore J, "Effect of femoral head size on wear of the polyethylene acetabular component" 72 : 518-528, 1990
• 25 Woo RY, "Dislocations after total hip arthroplasty" 64 : 1295-1306, 1982
• 26 Bader R, "Computer-based motion simulation of total hip prostheses with ceramic-on-ceramic wear couple. Analysis of implant design andorientation as influence parameters" 140 : 310-316, 2002
• 27 Ha YC, "Ceramic liner fracture after cementless alumina-on-alumina total hip arthroplasty" 458 : 106-110, 2007
• 28 Park YS, "Ceramic failure after total hip arthroplasty with an alumina-on-alumina bearing" JOURNAL BONE JOINT SURGERY INC 88 : 780-787, 2006
• 29 Hasegawa M, "Ceramic acetabular liner fracture in total hip arthroplasty with a ceramic sandwich cup" 18 : 658-661, 2003
• 30 Santavirta S, "Biocompatibility of polyethylene and host response to loosening of cementless total hip replacement" 297 : 100-110, 1993
• 31 Nizard R, "Alumina-on-alumina hip arthroplasty in patients younger than 30 years old" 466 : 317-323, 2008
• 32 Lee YK, "Alumina-on-Alumina Total Hip Arthroplasty A Concise Follow-up, at a Minimum of Ten Years, of a Previous Report" JOURNAL BONE JOINT SURGERY INC 92A (92A): 1715-1719, 201007
• 33 Boutin P, "Alumina and its use in surgery of the hip. (Experimental study)" 79 : 639-640, 1971
• 34 Widmer KH, "A simplified method to determine acetabular cup anteversion from plain radiographs" 19 : 387-390, 2004