期刊文献+

远端固定生物型假体在股骨翻修术中的应用 被引量:1

Application of uncemented distal fixation femoral stem combined with allograft in femoral revision with proximal bone defect
原文传递
导出
摘要 目的探讨远端固定生物型假体结合干燥同种异体骨植骨在近端骨缺损股骨翻修术中的应用疗效。方法自1999年7月至2004年1月,对16例(17髋)非感染性股骨假体松动患者进行翻修手术,其中2例为再次翻修,采用远端固定生物型股骨假体结合干燥同种异体骨植骨。男7例,女9例,年龄58~77岁,平均63岁,术后平均随访时间为35个月(18~56个月)。翻修前人工股骨头置换5例,全髋关节置换12例,从初次关节置换到翻修手术的间隔时间最短7年,最长16年,平均13.5年。股骨骨缺损根据Paprosky分型,Ⅰ型8髋,Ⅱ型6髋,ⅢA型3髋。翻修用假体:MP(Link)1髋,AML(DePuy)9髋,Full-coated(Zimmer)5髋,Enchelon(Smith-Nephew)股骨距替代型假体2髋。结果Harris评分从术前平均37分改善至术后平均88分,无患者发生再次松动。术后X线片显示植入骨愈合良好,假体部位骨皮质密度和厚度明显增加。结论远端固定生物型假体可以在股骨远端髓腔内获得可靠的轴向及抗旋转初始稳定性,干燥异体骨植骨能有效修复骨缺损,恢复骨量,骨愈合率高,两者结合运用于伴有近端骨缺损的股骨翻修术中,中短期疗效满意,远期疗效尚待进一步随访。 Objective To evaluate the clinical outcomes of the application of uncemented distal fixation stem combined with allograft in the femoral revision with proximal bone defect.Methods From July 1999 to January 2004, 17 aseptic loosening femoral stem were revised in 16 patients, and 2 of them were rerevision surgery. 7 Males, 9 Females, the average age of patients is 63 (58-77). The interval between the primary athroplasty and the revision is from 7 years to 16 years. Based on the Paprosky classification system, type Ⅰ was 8 cases; type Ⅱ was 6 cases; type ⅢA was 3 cases. Femoral stems for revision include 1 case of MP stem (Link), 9 cases of AML stem (DePuy), 5 cases of Full-coated stem (Zimmer) and 2 cases of Enchelon calcar replacement stem (Smith-Nephew).Results The average Harris hip score increased from 37 to 88 points. No loosening occurred delete after the revision. The radiographs obtained after the revision showed that bone graft healed well.Conclusions The application of uncemented distal fixation femoral stem combined with allograft could achieve good clinical result in the femoral revision with proximal bone defect.
出处 《中华关节外科杂志(电子版)》 CAS 2009年第5期21-24,共4页 Chinese Journal of Joint Surgery(Electronic Edition)
关键词 人工关节 翻修 股骨 骨缺损 Joint prosthesis Revision Femur Bone defect
  • 相关文献

参考文献10

  • 1McAuley JP,,Engh CA Jr.Femoral fixation in the face of considerable bone loss:cylindrical and extensively coated femoral components[].Clinical Orthopaedics and Related Research.2004
  • 2Jaiswal PK,Jagiello J,David LA,et al.Use of an‘internal proximal femoral replacement‘with distal fixation in revision arthroplasty of the hip[].J Bone and joint surgery Br.2008
  • 3Sporer SM,Paprosky WG.Revision total hip arthroplasty:the limits of fully coated stems[].Clinical Orthopaedics.2003
  • 4Taylor JW,Rorabeck CH.Hip revision arthroplasty.Approach to the femoral side[].Clinical Orthopaedics and Related Research.1999
  • 5Morgan HD,McCallister W,Cho MS,et al.Impaction allografting for femoral component revision:clinical update[].Clinical Orthopaedics and Related Research.2004
  • 6WF Mulroy,WH Harris.Revision total hip arthroplasty with use of so-called second-generation cementing techniques for aseptic loosening of the femoral component. A fifteen-year-average follow-up study[].Journal of Bone and Joint Surgery British Volume.1996
  • 7Berry DJ,Harmsen WS,Ilstrup D,et al.Survivorship of uncemented proximally porous-coated femoral components[].Clinical Orthopaedics.1995
  • 8Engh CA Jr,Hopper RHJr,Engh CA Sr.Distal ingrowth components[].Clinical Orthopaedics and Related Research.2004
  • 9Woolson ST,Delaney TJ.Failure of a proximally porous-coated femoral prosthesis in revision total hip arthroplasty[].Journal of Arthroplasty.1995
  • 10Weeden SH,Paprosky WG.Minimal11-year follow-up of exten-sively porous-coated stems in femoral revision total hip arthroplasty[].Journal of Arthroplasty.2002

同被引文献31

  • 1郝立波,王岩,周勇刚,李静东,唐佩福,王继芳.异体骨植骨重建在髋关节置换感染二期翻修中的应用[J].中国矫形外科杂志,2005,13(14):1066-1068. 被引量:9
  • 2李军,朱天岳,柴卫兵,卢宏章,刘震宁.髋关节翻修股骨侧植入物的取出[J].中华外科杂志,2006,44(8):527-528. 被引量:2
  • 3周勇刚,王岩.应用解剖型骨水泥股骨假体结合冻干骨打压植骨进行髋关节翻修[J].中国矫形外科杂志,2007,15(7):507-509. 被引量:15
  • 4Pierson JL,Harris WH.Effect of improved cementing techniques on the longevity of fixation in revision cemented femoral arthroplasties.Average 8.8-year follow-up period.J Arthroplasty. 1995;10(5):581-591.
  • 5Ulrich SD, Seyler TM, Bennett D, et al. Total hip arthroplasties: What are the reasons for revision?. Int Orthop. 2008;32(5): 597- 604.
  • 6Nath R, Gupta AK, Chakravarty U, Nath R, et al. Primary cemented total hip arthroplasty: 10 years follow-up. Indian J Orthop. 2010;44(3):283.
  • 7Gruner A,Heller KD.revision hip arthroplasty of the hip joint.Revision of the femur:which implant is indicated when? Orthopade.2009;38:667-680.
  • 8Kimura H, Kaneuji A.Revision total hip arthroplasty by nonmodular short and long cementles.JOrthop Sci.2008;13:335-340.
  • 9Park YS,Moon YW, Lim SJ.Revision total hip arthrop lasty using a fluted and tapered modular distal fixation stem with and without extended trochanteric osteotomy.J Arthrop.Jasty.2007,7:993-999.
  • 10Per Y Adolphson, Mats OFSalemyr, Olof G Skoldenberg, et al. Large femoral bone loss after hip revision using the uncemented proximally porous-coated Bi-Metric prosthesis: 22 hips followed for a mean of 6 years. Acta Orthop. 2009;80(1 ):14-19.

引证文献1

二级引证文献3

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部