Comparison of clinical effect between Tri-Lock BPS stem and Corail stem for treatment of type I developmental dysplasia of the hip
Kong Lingchao1, Chen Long2, Yang Xianteng2, Sun Li2, Tian Xiaobin1,2,3
1Graduate School of Zunyi Medical University, Zunyi 563003, China; 2Department of Orthopaedics, Guizhou Provincial People's Hospital, Guiyang 550002, China; 3Graduate School of Guizhou Medical University, Guiyang 550025, China
Abstract：Objective This study aimed to compare the clinical effect between Tri-Lock bone preservation stem(BPS)and Corail stem for treatment of Crowe typeⅠdevelopmental dysplasia of the hip (DDH).Methods This work analyzed data of 35 cases (40 hips) including 5 male cases and 30 female cases, with age of 26-77 (60.81±11.72) years, who were diagnosed with Crowe type Ⅰ DDH and admitted to the Joint Surgery Department of Guizhou People’s Hospital from January 2015 to April 2019. According to different femoral stems used, the patients were separated into two groups: observation group (17 cases, 20 hips using Tri-Lock BPS) and control group (18 cases, 20 hips using Corail femoral stems). Gender, age, canal flare index(CFI), initial stability of femoral stem, absolute length difference of lower limbs, and bone mass preservation area of the broadest part in femur lesser trochanter were compared between the two groups. Bone mass preservation volume between femur lesser and greater trochanter was reconstructed using Mimics 17.0. Complications related to femoral stems were recorded.Results There was no statistically significant difference in gender, age, CFI between the two groups(all P values >0.05). During the follow-up of 6 to 18 months, of which the mean duration was 12.6 months. The initial stability of femoral stems and the absolute length difference of lower limbs were not statistically significantly different between the two groups (P>0.05). The area of bone mass preservation in the broadest part in the femur lesser trochanter [(6.28±0.32) cm2], the volume of bone mass preservation between femur lesser and greater trochanter [(30.25±0.81) cm3] of patients in the observation group were all significantly higher than those of patients in the control group [(5.63±0.14) cm2, (17.74±0.33) cm3] (t=8.313, 64.099, all P values＜0.01). On the second day after the operation, no statistically significant difference was observed in the hip VAS pain score, the difference in the absolute length of the lower limbs, and the initial stability of the femoral stalk between the two groups (all P values>0.05). The difference in total HHS score and pain improvement between the observation and control group was statistically significant 12 weeks after the operation (t=2.098, 2.432, all P values<0.05). No statistically significant difference was found in hip functional movement and limb deformity between the two groups (all P values were>0.05). The incidence of complications in the observation group was 5.0% (1/20), which was lower than that of the control group (25.0%, 5/20). However, the difference was not statistically significant (χ2=1.765, P>0.05).Conclusions Compared with Corail femoral stem, Tri-Lock BPS is more minimally invasive, has better clinical effect and proximal femur bone mass preservation, and does not increase surgical complications.
孔令超, 陈龙, 杨先腾, 孙立, 田晓滨. Tri-Lock 骨保留型股骨柄与Corail柄在Crowe Ⅰ型发育性髋关节发育不良治疗中的应用效果比较[J]. 中华解剖与临床杂志, 2020, 25(4): 376-381.
Kong Lingchao, Chen Long, Yang Xianteng, Sun Li, Tian Xiaobin. Comparison of clinical effect between Tri-Lock BPS stem and Corail stem for treatment of type I developmental dysplasia of the hip. Chinese Journal of Anatomy and Clinics, 2020, 25(4): 376-381.
Chu L, He Z, Qu X, et al. Different subchondral trabecular bone microstructure and biomechanical properties between developmental dysplasia of the hip and primary osteoarthritis[J]. J Orthop Translat, 2020, 22:50-57. DOI:10.1016/j.jot.2019.09.001.
[2]
Seo LJ, Gabor J, Novikov D, et al. Outcomes in 385 developmental dysplastic hips requiring total hip arthroplasty[J]. Arch Orthop Trauma Surg, 2019, 139(5): 723-728. DOI:10.1007/s00402-019-03143-5.
[3]
Padilla JA, Anoushiravani AA, Feng JE, et al. The learning curve following adoption of a novel short-stem prosthesis in total hip arthroplasty: implications on short-term patient outcomes[J]. Eur J Orthop Surg Traumatol, 2019, 29(4): 819-825. DOI:10.1007/s00590-018-2355-z.
[4]
Gielis WP, van Oldenrijk J, Ten Cate N, et al. 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[J]. J Arthroplasty, 2019, 34(5): 912-919. DOI:10.1016/j.arth.2019.01.014.
[5]
Jo WL, Lee YK, Ha YC, et al. Frequency, developing time, intensity, duration, and functional score of thigh pain after cementless total hip arthroplasty[J]. J Arthroplasty, 2016, 31(6): 1279-1282. DOI:10.1016/j.arth.2015.12.016.
[6]
Ulivi M, Orlandini LC, Meroni V, et al. Clinical performance, patient reported outcome, and radiological results of a short, tapered, porous, proximally coated cementless femoral stem: results up to seven years of follow-up[J]. J Arthroplasty, 2018, 33(4): 1133-1138. DOI:10.1016/j.arth.2017.11.046.
[7]
Lidder S, Epstein DJ, Scott G. A systematic review of short metaphyseal loading cementless stems in hip arthroplasty[J]. Bone Joint J, 2019, 101-B(5): 502-511. DOI:10.1302/0301-620X.101B5.BJJ-2018-1199.R1.
[8]
Hammer A. The calcar femorale: a new perspective[J]. J Orthop Surg (Hong Kong), 2019, 27(2):2309499019848778. DOI:10.1177/2309499019848778.
[9]
Samy AM, El-Tantawy A. Stem length in primary cementless total hip arthroplasty: does it make a difference in bone remodeling?[J]. Eur J Orthop Surg Traumatol, 2019, 29(6): 1235-1242. DOI:10.1007/s00590-019-02437-z.
[10]
Huang C, Tan H, Kernkamp WA, et al. Effect of altered proximal femoral geometry on predicting femoral stem anteversion in patients with developmental dysplasia of the hip[J]. J Orthop Surg Res, 2019, 14(1): 420. DOI:10.1186/s13018-019-1491-4.
[11]
Mao C, Liang Y, Ding C, et al. The consistency between measurements of the femoral neck anteversion angle in DDH on three-dimensional CT and MRI[J]. Acta Radiol, 2016, 57(6): 716-720. DOI:10.1177/0284185115603244.
[12]
Snijders TE, van Erp J, de Gast A. Restoring femoral offset and leg length; the potential of a short curved stem in total hip arthroplasty[J]. J Orthop, 2019, 16(5): 396-399. DOI:10.1016/j.jor.2019.04.013.
[13]
Ortmaier R, Pichler H, Hitzl W, et al. Return to sport after short-stem total hip arthroplasty[J]. Clin J Sport Med, 2019, 29(6): 451-458. DOI:10.1097/JSM.0000000000000532.
[14]
Donner S, Rehbein P, Schneider M, et al. Return to sports and recreational activity after single-stage bilateral short-stem total hip arthroplasty: 5-year results of a prospective observational study[J]. Orthop J Sports Med, 2019, 7(9): 2325967119872746. DOI:10.1177/2325967119872746.
[15]
徐杰, 郭立成. Tri-Lock骨保留股骨柄在中青年THA术中的应用[J]. 中国骨与关节损伤杂志, 2015, 30(2): 117-120. DOI:10.7531/j.issn.1672-9935.2015.02.002.Xu J, Guo LC. Application of Tri-Lock bone preservation stem in THA for young and middle-aged patients[J]. Chinese Journal of Bone and Joint, 2015, 30(2): 117-120. DOI:10.7531/j.issn.1672-9935.2015.02.002.
2020, Vol. 25 
