Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have as...Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty （THA） in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. Methods： Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords ＂acetabular＂, ＂fracture＂, ＂arthroplasty＂, and ＂post traumatic arthritis＂ published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. Results： With 1830 studies were screened and data from 10 studies with 448 patients were included in this review, The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years, The mean Harris hip scores （HHS） improved from 41.5 pre-operatively, to 87.6 post-operatively, The most prevalent postoperative complications were heterotopic ossification （28% -63%）, implant loosening （1%-24%）, and infection （0%-16%）. The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. Conclusion： Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture （including soft tissue scarring, existing hardware, and acetabular bone loss） and the relatively high complication rates, THA in patients with VIA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.展开更多
目的:评价智能手机在人工全髋关节置换术(Total Hip Arthroplasty,THA)髋臼假体置入的应用效果及准确性。方法:采用随机数字表法将深圳市龙华区人民医院骨科2015年1月至2017年1月收治的120例THA髋臼假体置入患者分为研究组和对照组,每...目的:评价智能手机在人工全髋关节置换术(Total Hip Arthroplasty,THA)髋臼假体置入的应用效果及准确性。方法:采用随机数字表法将深圳市龙华区人民医院骨科2015年1月至2017年1月收治的120例THA髋臼假体置入患者分为研究组和对照组,每组60例,研究组在术中使用智能手机辅助,比较两组的临床疗效。结果:研究组总有效率高于对照组,并发症发生率、术前计划假体型号与实际使用假体型号差异低于对照组,差异均有统计学意义(P<0.05)。结论:使用智能手机辅助可以提高THA髋臼假体置入的操作精度,降低术后并发症,值得推广使用。展开更多
目的探讨初次行人工全髋关节置换术(total hip arthroplasty,THA)术中发生髋臼骨折的原因和处理方法。方法 2005年5月-2008年7月,9例9髋初次行THA患者术中发生髋臼骨折。男1例,女8例;年龄41～73岁,平均63.3岁。发育性髋关节发育不良4例...目的探讨初次行人工全髋关节置换术(total hip arthroplasty,THA)术中发生髋臼骨折的原因和处理方法。方法 2005年5月-2008年7月,9例9髋初次行THA患者术中发生髋臼骨折。男1例,女8例;年龄41～73岁,平均63.3岁。发育性髋关节发育不良4例,类风湿性关节炎2例,陈旧性股骨颈骨折1例,股骨头缺血性坏死1例,强直性脊柱炎1例。病程1～35年,平均19.5年。左髋3例,右髋6例。Harris评分为(40.4±2.9)分。患者均选择非骨水泥型假体。术中发生髋臼前壁骨折2例,后壁骨折6例,均属稳定型骨折,1例未作特殊处理,余7例给予3～4枚螺钉加强固定;后壁骨折伴后柱不全骨折1例,属不稳定型骨折,给予髋臼杯底植骨联合3枚螺钉固定。结果术后X线片检查示假体位置良好。切口均Ⅰ期愈合,无早期并发症发生。9例患者均获随访,随访时间1～4年,平均2年7个月。末次随访时Harris评分为(87.8±3.9)分,与术前比较差异有统计学意义(t=44.904,P=0.000)。X线片检查示,骨折均于术后8周达临床愈合;随访期间未发现髋臼假体周围透亮带及松动表现。结论初次行THA术前应仔细测量,术中充分显露,精细操作,避免暴力。非骨水泥型髋臼假体直径不应超过髋臼锉直径2 mm;对于骨质疏松患者,宜选用与髋臼锉直径相同的假体并用螺钉固定,或直接采用骨水泥型假体。一旦术中发生髋臼骨折,可根据骨折类型和假体稳定性选用增加螺钉固定或植骨配合多枚螺钉固定。展开更多
文摘Purpose： Posttraumatic arthritis （PTA） may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty （THA） in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. Methods： Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords ＂acetabular＂, ＂fracture＂, ＂arthroplasty＂, and ＂post traumatic arthritis＂ published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. Results： With 1830 studies were screened and data from 10 studies with 448 patients were included in this review, The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years, The mean Harris hip scores （HHS） improved from 41.5 pre-operatively, to 87.6 post-operatively, The most prevalent postoperative complications were heterotopic ossification （28% -63%）, implant loosening （1%-24%）, and infection （0%-16%）. The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. Conclusion： Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture （including soft tissue scarring, existing hardware, and acetabular bone loss） and the relatively high complication rates, THA in patients with VIA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.
文摘目的:评价智能手机在人工全髋关节置换术(Total Hip Arthroplasty,THA)髋臼假体置入的应用效果及准确性。方法:采用随机数字表法将深圳市龙华区人民医院骨科2015年1月至2017年1月收治的120例THA髋臼假体置入患者分为研究组和对照组,每组60例,研究组在术中使用智能手机辅助,比较两组的临床疗效。结果:研究组总有效率高于对照组,并发症发生率、术前计划假体型号与实际使用假体型号差异低于对照组,差异均有统计学意义(P<0.05)。结论:使用智能手机辅助可以提高THA髋臼假体置入的操作精度,降低术后并发症,值得推广使用。
文摘目的探讨初次行人工全髋关节置换术(total hip arthroplasty,THA)术中发生髋臼骨折的原因和处理方法。方法 2005年5月-2008年7月,9例9髋初次行THA患者术中发生髋臼骨折。男1例,女8例;年龄41～73岁,平均63.3岁。发育性髋关节发育不良4例,类风湿性关节炎2例,陈旧性股骨颈骨折1例,股骨头缺血性坏死1例,强直性脊柱炎1例。病程1～35年,平均19.5年。左髋3例,右髋6例。Harris评分为(40.4±2.9)分。患者均选择非骨水泥型假体。术中发生髋臼前壁骨折2例,后壁骨折6例,均属稳定型骨折,1例未作特殊处理,余7例给予3～4枚螺钉加强固定;后壁骨折伴后柱不全骨折1例,属不稳定型骨折,给予髋臼杯底植骨联合3枚螺钉固定。结果术后X线片检查示假体位置良好。切口均Ⅰ期愈合,无早期并发症发生。9例患者均获随访,随访时间1～4年,平均2年7个月。末次随访时Harris评分为(87.8±3.9)分,与术前比较差异有统计学意义(t=44.904,P=0.000)。X线片检查示,骨折均于术后8周达临床愈合;随访期间未发现髋臼假体周围透亮带及松动表现。结论初次行THA术前应仔细测量,术中充分显露,精细操作,避免暴力。非骨水泥型髋臼假体直径不应超过髋臼锉直径2 mm;对于骨质疏松患者,宜选用与髋臼锉直径相同的假体并用螺钉固定,或直接采用骨水泥型假体。一旦术中发生髋臼骨折,可根据骨折类型和假体稳定性选用增加螺钉固定或植骨配合多枚螺钉固定。
