人工全髋关节置换术“一钻研磨法”研磨髋臼的体会

Experience of a modified reaming technique in total hip arthroplasty

背景:人工全髋关节置换术(THA)传统的髋臼研磨方法存在研磨失误的可能性,影响髋臼假体的成功安放。目的:回顾性分析应用改进的THA研磨髋臼方法,即"一钻研磨法"的临床效果。方法:2013年10月至2018年10月45例45髋行初次THA时,直接使用测定的最大直径型号髋臼钻按标准规定的外展角和前倾角研磨放入髋臼内,即"一钻研磨法"。研磨直至髋臼窝完全消失时停止,再将稍大一号髋臼假体按预定角度打入。结果:45髋均一钻研磨成功,对应型号髋臼假体均被一次打入髋臼底并贴紧,预置角度无异动,检测髋臼假体固定牢靠。结论:"一钻研磨法"简化手术过程,减少研磨失误,提高髋臼研磨的准确性,增加髋臼假体压配合的有效性。

Background:The conventional reaming in total hip arthroplasty(THA)may occur reaming error and lead to unsatisfactory placement of the acetabular prosthesis.Objective:To retrospectively study the clinical efficacy of a modified reaming technique,which was named“single-step reaming”.Methods:The“single-step reaming”technique was used in 45 patients who underwent THA from October 2013 to October 2018.According to the acetabular diameter in preoperative templating,we selected the same size of the reamer to prepare for the acetabulum in the appropriate abduction and anteversion reaming down to the medial wall,followed by the press-fit of the prosthesis.Results:The reaming was successfully performed in all the 45 patients.The prostheses were all firmly positioned in satisfactory angles.Conclusions:Compared to the conventional reaming,the"single-step reaming"technique can provide a less possibility of unsatisfactory cup placement and an increase of accuracy in acetabular preparation,which will lead to greater efficacy of the press-fit.