Ng F Y, Chiu K Y, Yau W P, Ng T P, Tang W M
Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
J Orthop Surg (Hong Kong). 2004 Dec;12(2):168-72. doi: 10.1177/230949900401200206.
To review the outcome of revision hip arthroplasty using extensively coated femoral components.
We reviewed the results of revision involving 24 extensively porous-coated cementless femoral components in 23 patients, whose mean age was 52.4 years (range, 28.0-79.0 years). Most revisions were performed for aseptic loosening of the previously cemented femoral component. All patients were followed up for a minimum period of 24.0 months (mean, 61.1 months).
Of the 24 femoral stems, 20 showed bone ingrowth, 3 showed stable fibrous ingrowth, and one was unstable because of deep infection. Intra-operative anterior femoral diaphyseal perforation occurred in 2 hips during the insertion of straight femoral components of 200 mm. Postoperative radiographs displayed marked cortical erosion in 3 other hips and cortical perforation in one.
The results from the use of extensively coated femoral components were promising. Nevertheless, anterior cortical perforations were also common, which may be related to more bowing of the femora among the Chinese patients. Caution must be exercised when inserting a long, straight, extensively coated femoral component.
回顾使用广泛涂层股骨组件进行髋关节翻修术的结果。
我们回顾了23例患者中24个广泛多孔涂层非骨水泥股骨组件的翻修结果,这些患者的平均年龄为52.4岁(范围28.0 - 79.0岁)。大多数翻修是针对先前骨水泥固定股骨组件的无菌性松动进行的。所有患者均接受了至少24.0个月(平均61.1个月)的随访。
在24个股骨柄中,20个显示骨长入,3个显示稳定的纤维长入,1个因深部感染而不稳定。在插入200 mm直型股骨组件时,2例髋关节术中发生股骨干前部穿孔。术后X线片显示另外3例髋关节有明显的皮质侵蚀,1例有皮质穿孔。
使用广泛涂层股骨组件的结果令人鼓舞。然而,前部皮质穿孔也很常见,这可能与中国患者中股骨更多弯曲有关。插入长的、直的、广泛涂层股骨组件时必须谨慎。