Hueco libre en el cemento de la prótesis de cadera para reducir presión. (Alem.)

"Hueco libre en el cemento de la prótesis de cadera para reducir la presión intramedular."

Barden B, Seel W, Loer F, Konermann H.
Klinik fur Orthopadie und Orthopadische Chirurgie des St. Augustinus-Krankenhauses Duren. b_barden.sak-dn@clinet.de

PURPOSE: A hollow cementless femoral stem has been developed to reduce intramedullary pressure and fat embolism during implantation.

METHODS: In a prospective randomized clinical study, cementless hip stems (ALPHA-FIT) were implanted in 42 patients (24 women, 18 men, mean age: 65.9 years). In Group I (n=21) a solid standard stem was used. In Group II (n=21) a modified hollow stem was implanted with vertical and longitudinal communicating drill holes opening at the implant surface. During surgery the intramedullary pressure was measured by a cannula fixed distally.

RESULTS: During stem insertion the mean pressure was 82 mmHg (minimum-maximum, 12-259 mmHg) for Group I and 27 mmHg (minimum-maximum, 0-48 mmHg) for Group II. This difference was statistically significant (t-test, p < 0.00076). The pressure measured in Group II was similar to the base pressure before opening of the intramedullary canal (mean 35 mmHg; minimum-maximum, 4-72 mmHg). In both groups higher pressures were found for opening of the canal, drilling with the smallest drill size and rasping.

CONCLUSION: Using the hollow prosthesis, the intramedullary pressure could be reduced significantly. The higher pressures during preparation of the femoral canal need further research.

Z Orthop Ihre Grenzgeb. 2004 May-Jun;142(3):298-302.