Howard M B, Bruce W J M, Walsh W, Goldberg J A
Concord Repatriation General Hospital, Concord, Australia.
J Orthop Surg (Hong Kong). 2002 Jun;10(1):29-33. doi: 10.1177/230949900201000106.
The benefits of converting an ankylosed or arthrodesed hip to total hip arthroplasty have been reported in the literature as have the technical difficulties associated with this procedure. This review, however, outlines the experience of a single surgeon (WJMB) at a single institution using uncemented prostheses. Between November 1991 and June 1996, 5 arthrodesed hips underwent uncemented total hip arthroplasty in 4 males and 1 female. Clinical and radiological follow-up review was for at least three years in all patients. In general, patients were satisfied with the outcome of their surgery with Harris Hip scores improving from an average of 62 preoperatively to an average of 72 postoperatively. The surgical outcome in these difficult cases was not as satisfactory as for routine total hip arthroplasty. Meticulous preoperative planning is required to aim toward leg length restoration and restoration of the abductor moment arm. A modular prosthesis allows versatility at surgery.
文献中已报道了将强直性或已融合的髋关节转换为全髋关节置换术的益处,以及与该手术相关的技术难题。然而,本综述概述了单一机构的一位外科医生(WJMB)使用非骨水泥假体的经验。在1991年11月至1996年6月期间,5例已融合的髋关节在4名男性和1名女性患者中接受了非骨水泥全髋关节置换术。所有患者均进行了至少三年的临床和影像学随访复查。总体而言,患者对手术结果满意,Harris髋关节评分从术前平均62分提高到术后平均72分。这些疑难病例的手术结果不如常规全髋关节置换术令人满意。需要精心的术前规划以恢复肢体长度并恢复外展肌力矩臂。模块化假体在手术中具有通用性。