Vástagos femorales cortos para el reemplazo total de cadera primario en pacientes jóvenes. Resultados clínicos y biomecánicos*
Barra lateral del artículo
Publicado:
abr 24, 2023
Palabras clave:
Artroplastia total de cadera, tallo corto, artrosis de cadera
Contenido principal del artículo
Resumen
La artroplastia total de cadera es una cirugía eficaz para tratar la artrosis. Con el aumento de la necesidad de una mejor calidad de vida, este procedimiento se está realizando en pacientes más jóvenes. Pero, con la mayor expectativa de vida, también crece la demanda de múltiples cirugías de revisión para el mismo paciente. Esto plantea desafíos técnicos debido a la pérdida de hueso. Existe una necesidad creciente de identificar implantes duraderos y altamente funcionales que sean adecuados para la revisión futura. Aunque los vástagos femorales cementados eran la opción principal en el pasado, los vástagos femorales no cementados han logrado una fijación a largo plazo y excelentes resultados. Sin embargo, aún se pueden mejorar algunos problemas relacionados con la fijación. Los vástagos femorales cortos han sido desarrollados para abordar algunos de estos desafíos, mientras se mantienen los buenos resultados obtenidos con los vástagos convencionales. En este artículo, se analiza la experiencia tras 10 años de uso de vástagos femorales cortos en cirugías de cadera en pacientes jóvenes. Se comparan los resultados biomecánicos y la preservación ósea femoral, se reportan los resultados posoperatorios en relación con el regreso al deporte, y se evalúan las complicaciones relacionadas con su uso. El empleo de vástagos cortos en cirugía primaria de cadera brinda múltiples ventajas. La indicación de este tipo de implante está justificada en pacientes jóvenes y activos, con el objetivo de reproducir los resultados de los implantes convencionales con un menor consumo de hueso y la posibilidad de una revisión futura.
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Lucero, C. M., Slullitel, P. A., Díaz-Dilernia, F., Zanotti, G., Comba, F., & Buttaro, M. (2023). Vástagos femorales cortos para el reemplazo total de cadera primario en pacientes jóvenes. Resultados clínicos y biomecánicos*. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(2), 224-251. https://doi.org/10.15417/issn.1852-7434.2023.88.2.1725
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Artículo Especial
Derechos de autor 2023 Revista de la Asociación Argentina de Ortopedia y Traumatología
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Citas
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3. Kurtz S, Mowat F, Ong K, Chan N, Lau E, Halpern M. Prevalence of primary and revision total hip and knee arthroplasty in the United States from 1990 through 2002. J Bone Joint Surg Am 2005;87(7):1487-97. https://doi.org/10.2106/JBJS.D.02441
4. Rajaee SS, Campbell JC, Mirocha J, Paiement GD. Increasing burden of total hip arthroplasty revisions in patients between 45 and 64 years of age. J Bone Joint Surg Am 2018;100(6):449-58. https://doi.org/10.2106/JBJS.17.00470
5. Grübl A. Cementless total hip arthroplasty with the rectangular titanium Zweymüller stem. A concise follow-up, at a minimum of fifteen years, of a previous report. J Bone Joint Surg Am 2006;88(10):2210-5.
https://doi.org/10.2106/jbjs.e.00810
6. McLaughlin JR, Lee KR. Total hip arthroplasty with an uncemented femoral component. Excellent results at ten-year follow-up. J Bone Joint Surg Br 1997;79(6):900-7. https://doi.org/10.1302/0301-620x.79b6.7482
7. Eingartner C. Current trends in total hip arthroplasty. Ortop Traumatol Rehabil 2007;9(1):8-14. PMID: 17514169
8. Issa K, Pivec R, Wuestemann T, Tatevossian T, Nevelos J, Mont MA. Radiographic fit and fill analysis of a new second-generation proximally coated cementless stem compared to its predicate design. J Arthroplasty 2014;29(1):192-8. https://doi.org/10.1016/j.arth.2013.04.029
9. Reimeringer M, Nuño N, Desmarais-Trépanier C, Lavigne M, Vendittoli PA. The influence of uncemented femoral stem length and design on its primary stability: a finite element analysis. Comp Methods Biomech Biomed Engin 2013;16(11):1221-31. https://doi.org/10.1080/10255842.2012.662677
10. McTighe T, Keggi J, Stulberg D, Keppler L, Brazil D, McPherson E. Total Hip Stem Classification System. Reconstr Rev 2014;4(2):24-8. https://doi.org/10.15438/rr.v4i2.70
11. Feyen H, Shimmin AJ. Is the length of the femoral component important in primary total hip replacement? Bone Joint J 2014;96-B(4):442-8. https://doi.org/10.1302/0301-620X.96B4.33036
12. Dimitriou D, Tsai T-Y, Kwon Y-M. The effect of femoral neck osteotomy on femoral component position of a primary cementless total hip arthroplasty. Int Orthop 2015;39(12):2315-21. https://doi.org/10.1007/s00264-015-27391
13. Khanuja HS, Banerjee S, Jain D, Pivec R, Mont MA. Short bone-conserving stems in cementless hip arthroplasty. J Bone Joint Surg 2014;96(29):1742-52. https://doi.org/10.2106/jbjs.m.00780
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