Increased Persistent Mid-Thigh Pain After Short-Stem Compared With Wedge-Shaped Straight-Stem Uncemented Total Hip Arthroplasty at Medium-Term Follow-Up: A Randomized Double-Blinded Cross-Sectional Study

被引：13

作者：

Gielis, Willem Paul ^{[1
,2
,5
]}

van Oldenrijk, Jakob ^{[3
,6
]}

ten Cate, Nick ^{[1
]}

Scholtes, Vanessa A. B. ^{[1
]}

Geerdink, Carel H. ^{[4
]}

Poolman, Rudolf W. ^{[1
]}

机构：

[1] Joint Res, Dept Orthoped Surg, Amsterdam, Netherlands

[2] UMC Utrecht, Dept Orthoped Surg, Utrecht, Netherlands

[3] Erasmus MC, Dept Orthoped Surg, Rotterdam, Netherlands

[4] Ikazia Hosp, Dept Orthoped Surg, Rotterdam, Netherlands

[5] Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands

[6] Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

来源：

JOURNAL OF ARTHROPLASTY | 2019年 / 34卷 / 05期

关键词：

total hip arthroplasty; osteoarthritis; mid-thigh pain; patient-reported outcome; short stem; TITANIUM ZWEYMULLER STEM; FEMORAL STEM; REPLACEMENT; MINIMUM; PROSTHESIS; STABILITY; FIXATION; OUTCOMES; 10-YEAR; QUALITY;

D O I：

10.1016/j.arth.2019.01.014

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

Background: Femoral prosthesis design may impact the frequency of mid-thigh pain. We compared current, incidental, and persistentmid-thigh pain between the short-stem, Collum Femoris femur prosthesis, and the wedge shaped straight-stem, Zweymuller femur prosthesis and studied the associations between demographics, radiographic measurements, and mid-thigh pain. Methods: We contacted patients from a randomized controlled trial who underwent uncemented total hip arthroplasty (THA) for hip osteoarthritis at a mean follow-up of 44 months (range 24-64 months). Patients were specifically assessed for current (during assessment), incidental (any time postoperatively for > 1 week) mid-thigh pain, and persistent (any time postoperatively for > 2 years) mid-thigh pain. Furthermore, we used regression analysis to study associations between demographics, radiographic measurements, and mid-thigh pain. Results: One hundred forty of 150 patients (93%) responded to our assessment. Mean age at the time of operation was 62 years (+/- 7.0). Current mid-thigh pain occurred in 16 patients (23%) in the Collum Femoris Preserving (CFP) group compared with 10 patients (14%) in the Zweymuller group (P =.192). Incidental mid-thigh pain occurred in 24 patients (34%) in the CFP group compared with 15 patients (21%) in the Zweymuller group (P =.090). Persistent mid-thigh pain was found in 13 patients (19%) in the CFP group compared with five patients (7%) in the Zweymuller group (P =.043). Varus malalignment (odds ratio 1.819 [95% confidence interval 1.034-3.200]) and leg lengthening (odds ratio 1.107 per cm lengthening [95% confidence interval 1.026-1.195]) showed significant associations with mid-thigh pain. Conclusions: We found more persistent mid-thigh pain after short-stem uncemented THA compared to wedge-shaped straight-stem uncemented THA during medium-term follow-up. Varus malalignment and leg lengthening were associated with mid-thigh pain. (c) 2019 Elsevier Inc. All rights reserved.

引用

页码：912 / 919

页数：8