Influence of stem geometry on the stability of polished tapered cemented femoral stems
Influence of stem geometry on the stability of polished tapered cemented femoral stems
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DOI：
10.1302/0301-620x.87b7.16079
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发表时间：
2005-07-01
影响因子：
--
通讯作者：
Murray, DW
中科院分区：
文献类型：
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作者：
Glyn-Jones, S;Gill, HS;Murray, DW
抛光锥形股骨柄目前广泛用于骨水泥型全髋关节置换术，并且已经引入了许多此类设计。然而，股骨柄几何形状的变化可能对稳定性产生深远影响。具有宽的矩形近端部分的茎可能比那些近端较窄的茎更稳定。我们通过比较埃克塞特股骨柄与最近设计的CPS-Plus（肩关节更宽，横截面更矩形）的2年移位，检查了近端几何结构对稳定性的影响。假设这些设计特征将增加旋转稳定性，在植入后的前两年，两个股骨柄相对于股骨下沉约1 mm。发现埃克塞特股骨柄旋转至外翻（平均0.2度，SD 0.42度）和内旋（平均1.28度，SD 0.99度）。CPS-Plus未显示显著外翻旋转（平均0.2度，SD 0.42度）或内旋（平均-0.03度，SD 0.75度）。更宽、更矩形的横截面可提高旋转稳定性，并可能具有更好的长期结果。
Polished, tapered stems are now widely used for cemented total hip replacement and many such designs have been introduced. However, a change in stem geometry may have a profound influence on stability. Stems with a wide, rectangular proximal section may be more stable than those which are narrower proximally. We examined the influence of proximal geometry on stability by comparing the two-year migration of the Exeter stem with a more recent design, the CPS-Plus, which has a wider shoulder and a more rectangular cross-section. The hypothesis was that these design features would increase rotational stability.Both stems subsided approximately 1 mm relative to the femur during the first two years after implantation. The Exeter stem was found to rotate into valgus (mean 0.2 degrees, SD 0.42 degrees) and internally rotate (mean 1.28 degrees, SD 0.99 degrees). The CPS-Plus showed no significant valgus rotation (mean 0.2 degrees, SD 0.42 degrees) or internal rotation (mean -0.03 degrees, SD 0.75 degrees). A wider, more rectangular cross-section improves rotational stability and may have a better long-term outcome.