Berend Keith R, Lombardi Adolph V, Mallory Thomas H, Adams Joanne B, Dodds Kathleen L
Joint Implant Surgeons, Inc, Columbus, OH 43215, USA.
Clin Orthop Relat Res. 2004 Oct(427):162-70. doi: 10.1097/01.blo.0000142351.88039.e8.
The complications and outcomes in patients who had total femoral arthroplasty for salvage of a severely compromised femur were studied. The clinical scenarios included numerous revision total hip or knee arthroplasties, failed periprosthetic fractures, or recurrent infection treated with multiple radical debridement surgeries. Fifty-nine patients (average age, 73.7 years) were identified. At an average 4.8 years followup, adequate pain relief was achieved and Harris hip pain scores averaged 33.8 of 44 points, and knee pain scores averaged 42.8 of 50 points. Good function was achieved with 98% of patients able to ambulate and 43% using no assistive device or a cane only. There were 18 complications or subsequent surgeries. Infection and dislocation occurred in eight patients and seven patients, respectively. Total femoral arthroplasty for salvage of a severely compromised femur provides acceptable results even in the most difficult of cases.
对因严重受损股骨而行全股骨置换术患者的并发症及预后进行了研究。临床情况包括多次翻修全髋关节或膝关节置换术、假体周围骨折失败，或经多次根治性清创手术治疗的反复感染。共确定了59例患者（平均年龄73.7岁）。平均随访4.8年时，疼痛得到充分缓解，Harris髋关节疼痛评分平均为44分中的33.8分，膝关节疼痛评分平均为50分中的42.8分。98%的患者能够行走，43%的患者无需辅助装置或仅使用手杖即可实现良好功能。发生了18例并发症或后续手术。分别有8例患者发生感染，7例患者发生脱位。即使在最困难的病例中，因严重受损股骨而行全股骨置换术也能提供可接受的结果。
