Goldstein Wayne M, Branson Jill J
Illinois Bone and Joint Institute, University of Illinois at Chicago, Morton Grove, Ill, USA.
Orthopedics. 2005 Sep;28(9 Suppl):s1079-84. doi: 10.3928/0147-7447-20050902-16.
The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.
将先前的髋关节手术转换为全髋关节置换术可构建出耐用且解剖结构准确的假体。大多数采用骨水泥或非骨水泥设计的股骨假体都具有固定的近端锥形形状。由于先前为治疗转子间髋部骨折、近端股骨截骨术或用于治疗缺血性坏死的腓骨移植进行的髋关节手术，近端股骨的解剖结构发生了改变。模块化的S-ROM（美国印第安纳州华沙市的DePuy骨科公司）髋关节柄可解决这些问题，并能独立处理股骨的近端和远端部分。在准备和植入过程中，S-ROM髋关节柄对由螺钉和薄骨造成的潜在脆弱应力集中区域产生的环向应力较小。S-ROM髋关节柄还通过铣削穿过可能阻塞股骨髓腔的皮质骨来矫正先前扭曲的解剖结构，重建合适的股骨前倾角，并降低由于柔性钛槽柄导致术中或术后假体周围骨折的风险。对于具有挑战性的全髋关节重建手术，推荐使用S-ROM股骨干假体。
