背景:目前微创短柄的出现,相对全涂层锥形柄来说,有着更优异的股骨髓腔匹配度,极大的降低假体微动的风险。目的:进一步验证微创短柄AccoladeⅡ在CroweⅠ型发育性髋关节发育不良人工全髋关节置换中的应用效果。方法:统计分析应用Accolad...背景:目前微创短柄的出现,相对全涂层锥形柄来说,有着更优异的股骨髓腔匹配度,极大的降低假体微动的风险。目的:进一步验证微创短柄AccoladeⅡ在CroweⅠ型发育性髋关节发育不良人工全髋关节置换中的应用效果。方法:统计分析应用AccoladeⅡ生物型股骨柄假体人工全髋关节置换治疗16例CroweⅠ型发育性髋关节发育不良患者的临床资料,比较患者关节置换前后的双下肢长度差异变化,同时观察置换前后12周患者疼痛、髋关节功能情况及术后一般状况。结果与结论:(1)关节置换前后双下肢长度差异变化有显著性意义(P<0.05),置换前双下肢等长10例(62%),置换后15例(94%);(2)关节置换后髋臼外展角41°-54°(平均46.9°);(3)目测类比评分及Harris评分显著优于关节置换前;(4)术中出血量平均147 m L,手术时间平均72 min,住院时间平均7.2 d,(5)关节置换后3个月所有患者恢复良好无并发症;(6)结果表明:应用AccoladeⅡ生物型股骨柄假体的人工全髋关节置换治疗CroweⅠ型发育性髋关节发育不良安全、可靠,置换后髋关节功能恢复良好。展开更多
BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have...BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral preparation.AIM To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for THA.METHODS This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related outcomes.RESULTS Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to 95.CONCLUSION The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.展开更多
文摘背景:目前微创短柄的出现,相对全涂层锥形柄来说,有着更优异的股骨髓腔匹配度,极大的降低假体微动的风险。目的:进一步验证微创短柄AccoladeⅡ在CroweⅠ型发育性髋关节发育不良人工全髋关节置换中的应用效果。方法:统计分析应用AccoladeⅡ生物型股骨柄假体人工全髋关节置换治疗16例CroweⅠ型发育性髋关节发育不良患者的临床资料,比较患者关节置换前后的双下肢长度差异变化,同时观察置换前后12周患者疼痛、髋关节功能情况及术后一般状况。结果与结论:(1)关节置换前后双下肢长度差异变化有显著性意义(P<0.05),置换前双下肢等长10例(62%),置换后15例(94%);(2)关节置换后髋臼外展角41°-54°(平均46.9°);(3)目测类比评分及Harris评分显著优于关节置换前;(4)术中出血量平均147 m L,手术时间平均72 min,住院时间平均7.2 d,(5)关节置换后3个月所有患者恢复良好无并发症;(6)结果表明:应用AccoladeⅡ生物型股骨柄假体的人工全髋关节置换治疗CroweⅠ型发育性髋关节发育不良安全、可靠,置换后髋关节功能恢复良好。
文摘BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral preparation.AIM To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for THA.METHODS This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related outcomes.RESULTS Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to 95.CONCLUSION The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.
