Abstract
Centralising devices were introduced to ensure that the prosthesis is implanted in a neutral position and that a cement mantle of optimal thickness is achieved proximally and distally. A distal centralising device (DCD) is compared with a proximal midshaft centralising device (PCD) to test which one provides a more neutral prosthetic alignment. Thirty consecutive patients undergoing hemiarthroplasties for femoral neck fractures were studied prospectively. Patients were blindly randomised to receive either a femoral component with proximal midshaft centraliser or distal centraliser. Both components were implanted following the manufacturer’s protocol. Postoperative true anteroposterior and lateral radiographs were made to assess the stem position. There was no statistically significant difference between the two groups in zones 1, 2, 3, 4, 5, 6 and 7 in both anteroposterior and lateral radiographic measurements. DCP and PCD both have similar centralisation and cement mantle. Future studies should be done to evaluate their long-term effect.
Résumé
Objectif: un matériel permettant de bien centrer la prothèse a été utilisé de façon à avoir une prothèse en position neutre avec un manteau de ciment dont l’épaisseur doit être optimale aussi bien pour la partie proximale que distale. Le centralisateur DCD est comparé avec le matériel permettant de centraliser la prothèse PCD. Matériel et méthode: 30 patients consécutifs ont bénéficié d’une arthroplastie, après une fracture du col du fémur. L’étude a été prospective. Les patients ont bénéficié d’une randomisation en double aveugle de façon à recevoir soit un composant fémoral fixé par le centralisateur médio diaphysaire, soit un centralisateur distal. Les composants fémoraux ont été implantés selon les recommandations du fabriquant. Des radiographies face profil ont été réalisées de façon à évaluer la position de la queue de la prothèse. Résultats: il n’y a pas de différence significative entre les deux groupes dans les zones 1, 2, 3, 4, 5, 6 et 7 que se soit sur les radios de face ou de profil. En conclusion, DCP et PCD ont, toutes les deux, une fonction de centralisation et d’organisation du manteau de ciment. Des études ultérieures seront nécessaires pour évaluer les effets à long terme de cette technique.
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Aydin, N., Bezer, M., Akgulle, A.H. et al. Comparison of distal and proximal centralising devices in hip arthroplasty. International Orthopaedics (SICOT) 33, 945–948 (2009). https://doi.org/10.1007/s00264-008-0610-3
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DOI: https://doi.org/10.1007/s00264-008-0610-3