{"title":"锥形楔形无骨水泥柄 \"Accolade II \"的柄对准不会影响全髋关节置换术后 5 年的骨矿物质密度","authors":"Masashi Tsujino MD , Kentaro Iwakiri MD, PhD , Yoichi Ohta MD, PhD , Yukihide Minoda MD, PhD , Akio Kobayashi MD, PhD , Hiroaki Nakamura MD, PhD","doi":"10.1016/j.artd.2024.101433","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to investigate the relationship between 3-dimensional (3D) alignment and postoperative bone mineral density (BMD) changes with Accolade II tapered wedge stems, which have a different proximal shape from other tapered wedge stems, up to 5 years after primary total hip arthroplasty.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the hips of 89 patients who underwent total hip arthroplasty using the second-generation proximally coated cementless stem (Accolade II; Stryker Orthopedics, Mahwah, NJ) at our institution from 2014 to 2018 over a 5-year follow-up. We evaluated the relationship between stem alignment, measured using 3D-templating software, and BMD changes in the 7 Gruen zones and compared the data with those from a former study using other short taper-wedge stems.</p></div><div><h3>Results</h3><p>BMDs in zones 1 and 7 continued to decrease gradually every year after surgery, and BMD in zone 7 showed the largest decrease (21%) from baseline over 5 years. No correlation was found between stem alignment (varus/valgus, flexion/extension, and anteversion/retroversion) and changes in BMD in each zone over 5 years.</p></div><div><h3>Conclusions</h3><p>Our data showed no correlation between 3D stem alignment and changes in BMD in each Gruen zone over 5 years. This suggests that the Accolade II stem may fit better into any shape of the proximal medullary canal because of its unique characteristics.</p></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352344124001183/pdfft?md5=978aa693e08b6ff76f1b3eef75e3d170&pid=1-s2.0-S2352344124001183-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Stem Alignment With the Tapered Wedge Cementless Stem \\\"Accolade II\\\" Does Not Affect Bone Mineral Density Over 5 Years After Total Hip Arthroplasty\",\"authors\":\"Masashi Tsujino MD , Kentaro Iwakiri MD, PhD , Yoichi Ohta MD, PhD , Yukihide Minoda MD, PhD , Akio Kobayashi MD, PhD , Hiroaki Nakamura MD, PhD\",\"doi\":\"10.1016/j.artd.2024.101433\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>This study aimed to investigate the relationship between 3-dimensional (3D) alignment and postoperative bone mineral density (BMD) changes with Accolade II tapered wedge stems, which have a different proximal shape from other tapered wedge stems, up to 5 years after primary total hip arthroplasty.</p></div><div><h3>Methods</h3><p>We retrospectively analyzed the hips of 89 patients who underwent total hip arthroplasty using the second-generation proximally coated cementless stem (Accolade II; Stryker Orthopedics, Mahwah, NJ) at our institution from 2014 to 2018 over a 5-year follow-up. We evaluated the relationship between stem alignment, measured using 3D-templating software, and BMD changes in the 7 Gruen zones and compared the data with those from a former study using other short taper-wedge stems.</p></div><div><h3>Results</h3><p>BMDs in zones 1 and 7 continued to decrease gradually every year after surgery, and BMD in zone 7 showed the largest decrease (21%) from baseline over 5 years. No correlation was found between stem alignment (varus/valgus, flexion/extension, and anteversion/retroversion) and changes in BMD in each zone over 5 years.</p></div><div><h3>Conclusions</h3><p>Our data showed no correlation between 3D stem alignment and changes in BMD in each Gruen zone over 5 years. This suggests that the Accolade II stem may fit better into any shape of the proximal medullary canal because of its unique characteristics.</p></div>\",\"PeriodicalId\":37940,\"journal\":{\"name\":\"Arthroplasty Today\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2352344124001183/pdfft?md5=978aa693e08b6ff76f1b3eef75e3d170&pid=1-s2.0-S2352344124001183-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroplasty Today\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352344124001183\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroplasty Today","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352344124001183","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Stem Alignment With the Tapered Wedge Cementless Stem "Accolade II" Does Not Affect Bone Mineral Density Over 5 Years After Total Hip Arthroplasty
Background
This study aimed to investigate the relationship between 3-dimensional (3D) alignment and postoperative bone mineral density (BMD) changes with Accolade II tapered wedge stems, which have a different proximal shape from other tapered wedge stems, up to 5 years after primary total hip arthroplasty.
Methods
We retrospectively analyzed the hips of 89 patients who underwent total hip arthroplasty using the second-generation proximally coated cementless stem (Accolade II; Stryker Orthopedics, Mahwah, NJ) at our institution from 2014 to 2018 over a 5-year follow-up. We evaluated the relationship between stem alignment, measured using 3D-templating software, and BMD changes in the 7 Gruen zones and compared the data with those from a former study using other short taper-wedge stems.
Results
BMDs in zones 1 and 7 continued to decrease gradually every year after surgery, and BMD in zone 7 showed the largest decrease (21%) from baseline over 5 years. No correlation was found between stem alignment (varus/valgus, flexion/extension, and anteversion/retroversion) and changes in BMD in each zone over 5 years.
Conclusions
Our data showed no correlation between 3D stem alignment and changes in BMD in each Gruen zone over 5 years. This suggests that the Accolade II stem may fit better into any shape of the proximal medullary canal because of its unique characteristics.
期刊介绍：
Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.
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