长柄广泛涂层非骨水泥假体在股骨骨缺损翻修中的应用

Uncemented long stem prosthesis with extensive porocoat for revision of failing femoral prostheses with bone defects

目的评价长柄广泛涂层非骨水泥假体在股骨假体失败并骨缺损翻修中的疗效。方法1997年4月-2001年4月，用长柄广泛涂层非骨水泥假体对73例股骨假体失败合并股骨骨缺损患者进行翻修，其中PaproskyⅠ型5例，Ⅱ型40例，ⅢA型9例。结果术后54例获得随访，平均随访8．3年，翻修假体均获得良好的稳定，尚未发现假体失败者；术后平均疼痛与行走积分明显提高。结论对股骨近端骨缺损者用长柄广泛涂层非骨水泥假体进行翻修，假体稳定并获得骨长入，短期随访无并发症，是一个良好的治疗选择。

Objective To evaluate the outcome of an uneemented, extensively coated, long stem prosthesis in the treatment of failing femoral prosthesis with femoral bone defection. Methods From April 1997 to April 2001, 73 eases of failing femoral prosthesis were revised with uneemented extensively coated long stem prostheses. Five eases were Paprosky type Ⅰ , 40 eases were Paprosky type Ⅱ and 9 eases were Paprosky type Ⅲ A. Results Of the 73 eases, 54 were followed up with a mean of 8.3 years. 54 stems aehieved stabilization with 100% femoral prosthesis survivalship. The mean modified D＇Aubigne and Postel scores improved signitieantly. Conclusions Revision of proximal femoral defects with uneemented extensively coated long stem prostheses favors bone ingrowth and stability, without significant complications occurring as was shown in a shoal-term follow-up, and therefore is a good alternative.