Minimum Ten-Year Follow-UP of Computed Tomography Based, Custom Cementless Stem After Intertrochanteric Osteotomy for Dysplastic Hips.

• 資料種別: 博士論文
• タイトル: Minimum Ten-Year Follow-UP of Computed Tomography Based, Custom Cementless Stem After Intertrochanteric Osteotomy for Dysplastic Hips.
• 著者・編者: Masuda, Yoshihide; Kawate, Kenji; Ohmura, Tetsuji; Munemoto, Mitsuru; Uchihara, Yoshinobu; Tanaka, Yasuhito
• 著者標目: Masuda, Yoshihide; Kawate, Kenji; Ohmura, Tetsuji; Munemoto, Mitsuru; Uchihara, Yoshinobu; Tanaka, Yasuhito
• 出版事項: 奈良医学会
• 出版年月日等: 2016-12-31
• 出版年（W3CDTF）: 2016-12-31
• 並列タイトル等: 臼蓋形成不全の股関節に行った転子間骨切り術後症例に対するカスタムメイドセメントレスステムの術後10年以上の成績
• タイトル（掲載誌）: Journal of Nara Medical Association
• 巻号年月日等（掲載誌）: 67 4,5,6
• 掲載巻: 67
• 掲載号: 4,5,6
• 掲載ページ: 65-72
• ISSN（掲載誌）: ISSN : 1345-0069
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2018-06-27
• 報告番号: 乙第1419号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: primary total hip arthroplasty; femoral osteotomy; CT based custom stem; fixation; stress shielding
• 対象利用者: 一般
• 一般注記: type:Thesis; Background: During fixation of total hip arthroplasty (THA) after osteotomy, it is difficult to obtain a good cement mantle with a cemented stem and to obtain good fit along the medullary canal with a ready-made stem. We developed a CT-based custom stem, which was inserted after osteotomy in THA. Methods: We investigated 32 hips in 28 patients. The mean patient age at surgery was 62 and the mean follow-up period was 13 years. The previous osteotomy was intertrochanteric varus femoral osteotomy in 14 hips, intertrochanteric valgus femoral osteotomy in 17, and Schanz osteotomy in one. CT studies were obtained with a 5 mm slice intervals and 2 mm slice width. We produced stems made of Ti-6Al-4V. The stems did not have collars and the proximal third was coated with a 400-μ. m-thick porous coating covered with 20-μ m-hydroxyapatite (HA) coating. Results: The Harris Hip Score improved from a preoperative mean of 49.9 points to a postoperative mean of 82.7 points. One patient complained of postoperative thigh pain. Fractures occurred in two hips. Dislocation occurred in three patients. To date. no patient has reqired revision of the stem due to aseptic loosening. There was bone-ingrown fixation in all hips. Severe stress shielding was found in 14 hips (44%) Conclusion: Stable fixation was achieved with the proximal press-fit of the custom stem. Although stress shielding was observed in 14 hips, excellent results were obtained over a follow-up period of 10 years with this custom stem system for hips after intertrochanteric femoral osteotomy.; 博士（医学）・乙第1419号・平成30年6月27日; identifier:Journal of Nara Medical Association Vol.67 No.4,5,6 p.65-72 (2016.12); identifier:13450069; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3358; identifier:Journal of Nara Medical Association, 67(4,5,6): 65-72
• オンライン閲覧公開範囲: インターネット公開
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3358/4/01%e4%b9%991419%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3358/5/02%e4%b9%991419%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3358/1/03%e4%b9%991419%e6%9c%ac%e6%96%87.pdf fulltext