TY - JOUR T1 - Analysis of the complications of the collum femoris preserving (CFP) prostheses TT - Femur boyun koruyucu (FBK) protezlerin yol açtığı komplikasyonların analizi AU - Li, Mingqing AU - Hu, Yihe AU - Xie, Jie PY - 2015 DA - January DO - 10.3944/AOTT.2014.13.0060 JF - Acta Orthopaedica et Traumatologica Turcica PB - Turkish Association of Orthopaedics and Traumatology WT - DergiPark SN - 1017-995X SP - 623 EP - 627 VL - 48 IS - 6 LA - en AB - Objective: The aim of this study was to evaluate the clinical and radiological outcomes and complications of total hip arthroplasty (THA) using the collum femoris preserving (CFP) prosthesis.Methods: The study included the 142 hips of 125 patients (mean age: 50 years; range: 38 to 60 years) who underwent THA with CFP prosthesis between January 2004 and December 2011. There were 70 males (82 hips) and 55 females (60 hips). Patients were assessed using the Harris hip score (HHS) and visual analog scale (VAS). Radiographs were evaluated according to the Gruen zones and DeLee and Charnley zones to assess the prosthesis position, loosening and ectopic ossification.Results: Follow-up was obtained over 4.72±2.16 (range: 1 to 8.4) years and no patients were lost to follow-up. Mean HHS improved from 51.43±4.14 points preoperatively to 90.27±6.60 points postoperatively, while VAS scores decreased from 8.3±3.12 to 2.1±1.54 by the final review. The HHS revealed excellent and good results in 87.4% of patients. Mild ectopic ossification occurred in 4 cases (2.8%), which were all Grade 1 according to the Brooker classification and without clinical symptoms. In 5 cases (3.5%), bone loss was found in the proximal femur. Radiolucent lines surrounding the stem were not observed in any case. There was no prosthesis loosening or femoral prosthesis subsidence. The survival rate was 100% for the femoral and acetabular components. Ten fractures (7%) of the lateral femoral diaphysis at the tip of the stem occurred during surgery and none of these required additional treatment. No infection, dislocation or deep vein thrombosis was observed.Conclusion: Total hip arthroplasty with CFP prosthesis appears to be a good option for young patients for a variety of etiologies but close attention should be paid to the prevention of complications. KW - Arthroplasty KW - collum femoris preserving prosthesis KW - follow-up KW - hip joint N2 - Amaç: Bu çalışmanın amacı femur boyun koruyucu (FBK) protez kullanımının, total kalça artroplastisindeki (TKA) klinik ve radyolojik sonuçlarını ve komplikasyonlarını değerlendirmekti.Çalışma planı: Çalışmada, Ocak 2004 ve Aralık 2011 tarihleri arasında FBK protezi ile TKA uygulanan 125 hastanın (70 erkek, 55 kadın; ortalama yaş: 50, dağılım: 38-60) 142 (82 erkek, 60 kadın) kalçası değerlendirildi. Hasta skorlamaları Harris kalça skoru (HKS) ve görsel analog skala (GAS) ile yapıldı. Radyografiler protez pozisyonu, gevşemesi ve ektopik kemikleşme analizinde kullanılan Gruen bölgeleri ile DeLee ve Charnley bölgelerine göre değerlendirildi.Bulgular: Ortalama 4.72±2.16 (dağılım:1-8.4) yıllık takip sırasında hiçbir hasta çalışmayı terk etmedi. Cerrahi öncesi 8.3±3.12 olan GAS skoru son takipte 2.1±1.54’e gerilerken, HKS’nin 51.43±4.14 puandan 90.27±6.60 puana geliştiği görüldü. Hastaların %87.4’ünde HKS iyi ve mükemmel olarak değerlendirildi. Brooker sınıflandırmasına göre tamamı Evre 1 olan 4 olguda (%2.8) klinik semptom olmaksızın hafif ektopik kemikleşme izlendi. Beş hastada (%3.5) proksimal femurda kemik kaybı bulundu. Stemi çevreleyen radyolüsen hatlar hiçbir olguda gözlenmedi. Yine hiçbir olguda protez gevşemesi veya femoral protez çökmesi saptanmadı. Femoral ve asetabular komponentler için sağkalım oranı %100 olarak bulundu. Ameliyat sırasında stem ucunda lateral femoral diyafizde oluşan 10 (%7.1) kırık için ek bir tedavi gereksinimi oluşmadı. Hiçbir olguda enfeksiyon, kayma ya da derin ven trombozu gözlenmedi.Çıkarımlar: Femur boyun koruyucu protez ile total kalça artroplastisi değişik etiyolojileri olan genç hastalar için iyi bir seçenek olsa da, komplikasyonların engellenmesi için yakın takip şarttır. CR - Molli RG, Lombardi AV Jr, Berend KR, Adams JB, CR - Sneller MA. A short tapered stem reduces intraoperative CR - complications in primary total hip arthroplasty. Clin Or CR - thop Relat Res 2012;470:450-61. CrossRef 2. Lingard EA, Muthumayandi K, Holland JP. Comparison CR - of patient-reported outcomes between hip resurfacing and CR - total hip replacement. J Bone Joint Surg Br 2009;91:1550- 4. CrossRef 3. Killampalli VV, Kundra RK, Chaudhry F, Chowdhry M, CR - Fisher NE, Reading AD. Resurfacing and uncemented ar CR - throplasty for young hip arthritis: functional outcomes at CR - 5 years. Hip Int 2009;19:234-8. 4. Goebel D, Schultz W. The Mayo cementless femoral CR - component in active patients with osteoarthritis. Hip Int CR - 2009;19:206-10. 5. Ghera S, Pavan L. The DePuy Proxima hip: a short stem CR - for total hip arthroplasty. Early experience and technical CR - considerations. Hip Int 2009;19:215-20. 6. Ettinger M, Ettinger P, Lerch M, Radtke K, Budde S, Eze CR - chieli M, et al. The NANOS short stem in total hip ar CR - throplasty: a mid term follow-up. Hip Int 2011;21:583-6. 7. Zeh A, Weise A, Vasarhelyi A, Bach AG, Wohlrab D. CR - Medium-term results of the Mayo™ short-stem hip pros CR - thesis after avascular necrosis of the femoral head. [Article CR - in German] Z Orthop Unfall 2011;149:200-5. [Abstract] 8. Pipino F, Molfetta L. Femoral neck preservation in total CR - hip replacement. Ital J Orthop Traumatol 1993;19:5-12. 9. Gruen TA, McNeice GM, Amstutz HC. “Modes of fail CR - ure” of cemented stem-type femoral components: a ra CR - diographic analysis of loosening. Clin Orthop Relat Res CR - 1979;141:17-27. 10. DeLee JG, Charnley J. Radiological demarcation of ce CR - mented sockets in total hip replacement. Clin Orthop CR - Relat Res 1976;121:20-32. 11. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. CR - Ectopic ossification following total hip replacement. Inci CR - dence and a method of classification. J Bone Joint Surg Am CR - 1973;55:1629-32. 12. Pipino F, Calderale PM. Biodynamic total hip prosthesis. CR - Ital J Orthop Traumatol 1987;13:289-97. 13. Pipino F, Molfetta L, Grandizio M. Preservation of the CR - femoral neck in hip arthroplasty: results of a 13 to 17 year CR - follow-up. J Orthop Traumatol 2000;1:31-9. CrossRef 14. Briem D, Schneider M, Bogner N, Botha N, Gebauer M, CR - Gehrke T, et al. Mid-term results of 155 patients treated CR - with a collum femoris preserving (CFP) short stem pros CR - thesis. Int Orthop 2011;35:655-60. CrossRef 15. Kinov P, Radl R, Zacherl M, Leithner A, Windhager R. CR - Correlation between thigh pain and radiological findings CR - with a proximally porous-coated stem. Acta Orthop Belg CR - 2007;73:618-24. 16. Davidson D, Pike J, Garbuz D, Duncan CP, Masri BA. CR - Intraoperative periprosthetic fractures during total hip ar CR - throplasty. Evaluation and management. J Bone Joint Surg CR - Am 2008;90:2000-12. CrossRef 17. Jakubowitz E, Seeger JB, Lee C, Heisel C, Kretzer JP, CR - Thomsen MN. Do short-stemmed-prostheses induce CR - periprosthetic fractures earlier than standard hip stems? A CR - biomechanical ex-vivo study of two different stem designs. CR - Arch Orthop Trauma Surg 2009;129:849-55. CrossRef 18. Chen HH, Morrey BF, An KN, Luo ZP. Bone remodeling CR - characteristics of a short-stemmed total hip replacement. J CR - Arthroplasty 2009;24:945-50. CrossRef 19. Gillies RM, Kohan L, Cordingley R. Periprosthetic bone CR - remodelling of a collum femoris preserving cementless ti CR - tanium femoral hip replacement. Comput Methods Bio CR - mech Biomed Engin 2007;10:97-102. CrossRef 20. Hayashi S, Nishiyama T, Fujishiro T, Kanzaki N, Hashi CR - moto S, Kurosaka M. Periprosthetic bone mineral density CR - with a cementless triple tapered stem is dependent on dai CR - ly activity. Int Orthop 2012;36:1137-42. CrossRef 21. Rama KR, Vendittoli PA, Ganapathi M, Borgmann R, CR - Roy A, Lavigne M. Heterotopic ossification after surface CR - replacement arthroplasty and total hip arthroplasty: a ran CR - domized study. J Arthroplasty 2009;24:256-62. CrossRef 22. Ritter MA, Galley M. Heterotopic bone formation follow CR - ing resurfacing total hip arthroplasty. HSS J 2011;7:41-3. UR - https://doi.org/10.3944/AOTT.2014.13.0060 L1 - https://dergipark.org.tr/en/download/article-file/170515 L1 - https://dergipark.org.tr/en/download/article-file/170514 ER -