Hube R, Zaage M, Hein W, Reichel H
Universitätsklinik und Poliklinik für Orthopädie, Martin-Luther-Universität Halle-Wittenberg.
Orthopade. 2004 Nov;33(11):1249-58. doi: 10.1007/s00132-004-0711-7.
Total hip arthroplasty has become one of the most successful standard procedures in orthopedic surgery. With a more frequent use in young and active patients bone saving procedures become more important. The goal is to save good bone stock for the revision procedure. One example of conservative femoral implants is the Mayo-stem with reported long term results. The stem design allows a metaphyseal intertrochanteric multipoint fixation for primary fixation. The surgical technique is simple. Using a transgluteal approach, the medial preparation of the femoral neck decreases significantly the irritation of the abductor tendons. In a prospective-randomized study, the early functional results with the Mayo-stem were significantly better than the results achieved with a cement-free standard stem. The Mayo-stem may not be indicated for every hip situation. Its use, however, in cases with normal anatomy contributes to save autologeous bone. Therefore, this short stem is a sensible alternative to standard stems.
全髋关节置换术已成为骨科手术中最成功的标准手术之一。随着其在年轻活跃患者中的使用越来越频繁，保骨手术变得更加重要。目标是为翻修手术保留良好的骨量。保守型股骨植入物的一个例子是有长期疗效报道的梅奥柄。该柄的设计允许在干骺端转子间进行多点固定以实现初次固定。手术技术简单。采用经臀入路，股骨颈的内侧准备可显著减少对外展肌腱的刺激。在一项前瞻性随机研究中，使用梅奥柄的早期功能结果明显优于使用无水泥标准柄所取得的结果。梅奥柄可能并非适用于所有髋关节情况。然而，在解剖结构正常的病例中使用它有助于保留自体骨。因此，这种短柄是标准柄的一种明智替代方案。
