Equivalent hip stem fixation by Hi-Fatigue G and Palacos R+G bone cement: a randomized radiostereometric controlled trial of 52 patients with 2 years' follow-up.
Equivalent hip stem fixation by Hi-Fatigue G and Palacos R+G bone cement: a randomized radiostereometric controlled trial of 52 patients with 2 years' follow-up.
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DOI：
10.1080/17453674.2019.1595390
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发表时间：
2019-06-01
影响因子：
3.7
通讯作者：
Stilling, Maiken
中科院分区：
文献类型：
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作者：
Jorgensen, Peter B;Lamm, Martin;Stilling, Maiken
背景和目的-骨水泥型股骨柄的长期固定依赖于几个因素，包括骨水泥粘附和疲劳。Hi-Fatigue是一种较新的第三代骨水泥，在室温下具有低粘度特性，在实验室测试环境中具有良好的机械强度和稳定的骨-骨水泥界面。Palacos骨水泥具有极佳的10年生存率，被视为金标准。我们使用放射立体测量法比较了Hi-Fatigue和Palacos骨水泥固定后的股骨柄下沉。患者和方法-在一项患者盲法随机对照试验中，52例平均年龄76岁（71-87岁）的骨关节病患者（30名女性）接受了Hi-Fatigue G或Palacos R+G骨水泥固定无领、抛光、双锥形股骨柄（CPT）。将钽珠插入假体周围骨中。术后、术后3个月、6个月、1年和2年获得仰卧位立体X线片。记录术前、术后1年和2年的牛津髋关节评分（OHS）和VAS疼痛。对水泥工作时间和性能进行了登记。结果-在2年时，Hi-Fatigue和Palacos的股骨柄平均下沉量相似，分别为1.12 mm（95% CI 0.96-1.29）和1.19 mm（CI 1.03-1.34）。同样，骨水泥组之间的股骨柄版本相当。骨水泥组之间的平均OHS和VAS疼痛相似。骨水泥组之间的骨水泥工作时间相似，但Hi-Fatigue的平均固化时间（13.7分钟）长于Palacos（11.6分钟）。解释-我们发现使用Hi-Fatigue和Palacos骨水泥插入的CPT股骨柄在2年随访前的移位相似且通常较低，这表明使用两种骨水泥插入的抛光锥形股骨柄的长期存活率良好。
Background and purpose - Long-term fixation of cemented femoral stems relies on several factors including cement adhesion and fatigue. Hi-Fatigue is a newer third-generation bone cement with low-viscosity properties at room temperature, good mechanical strength, and stable bone-cement interface in a laboratory testing environment. Palacos bone cement has excellent 10-year survival and is considered gold standard. We compared stem subsidence after fixation with Hi-Fatigue and Palacos bone cements using radiostereometry. Patients and methods - In a patient-blinded randomized controlled trial, 52 patients (30 women) at mean age 76 years (71-87) with osteoarthrosis and no osteoporosis received Hi-Fatigue G or Palacos R+G cement fixation of collarless, polished, double-tapered stems (CPT). Tantalum beads were inserted in the periprosthetic bone. Supine stereoradiographs were obtained postoperatively, 3 months, 6 months, 1 year, and 2 years after surgery. Oxford Hip Score (OHS) and VAS pain were recorded preoperatively and 1 and 2 years after surgery. Cement working times and properties were registered. Results - At 2 years, mean stem subsidence of 1.12mm (95% CI 0.96-1.29) for Hi-Fatigue and 1.19mm (CI 1.03-1.34) for Palacos was similar. Likewise, stem version was comparable between cement groups. Mean OHS and VAS pain were similar between cement groups. Cement working times were similar between cement groups, but the mean curing time was longer for Hi-Fatigue (13.7min) than for Palacos (11.6min). Interpretation - We found similar and generally low migration of CPT femoral stems inserted with Hi-Fatigue and Palacos bone cement until 2 years' follow-up, which indicates a good long-term survival of polished taper femoral stems inserted with both cement types.