Taper-wedge stem suitable for anterior approach total hip arthroplasty:Adequate biomechanical reconstruction parameters and excellent clinical outcome at mid-term follow-up  

作　　者：Carlo Trevisan Antonino Salvatore Lombardo Gianluca Gallinari Marco Zeppieri Raymond Klumpp 

机构地区：[1]UOC Ortopedia e Traumatologia,Ospedale Bolognini Seriate ASST,Bergamo Est 24068,Italy [2]Department of Ophthalmology,University Hospital of Udine,Udine 33100,Italy [3]UOC Ortopedia e Traumatologia,Ospedale Treviglio-Caravaggio ASST,Bergamo Ovest 24047,Italy

出　　处：《World Journal of Orthopedics》2022年第12期1047-1055,共9页世界骨科杂志（英文版）

摘　　要：BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral preparation.AIM To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for THA.METHODS This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related outcomes.RESULTS Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to 95.CONCLUSION The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.

关 键 词：Total hip arthroplasty ORTHOPEDICS Direct anterior approach Orthopedic surgery Stem implantation Accolade II stem 

分 类 号：R687.4[医药卫生—骨科学]