Gutiérrez Del Alamo José, Garcia-Cimbrelo Eduardo, Castellanos Vicente, Gil-Garay Enrique
Orthopaedic Department, Hospital La Paz, Madrid, Spain.
J Arthroplasty. 2007 Jun;22(4):515-24. doi: 10.1016/j.arth.2006.04.029. Epub 2007 Mar 9.
We used 79 Wagner SL stems (Sulzer Orthopedics, Baar, Switzerland) in femoral revisions with a minimum 5-year follow-up. There were 11 dislocations. A limb length discrepancy and limp were frequent. One loosened stem was rerevised. The cumulative probability of not having a stem revision for any reason was 92.3% in the best case scenario. Stem subsidence was associated with poor femoral canal filling. Definite proximal new bone regeneration (50 hips) was associated with an absence of major bone defects (P = .01). Lateral and medial femoral cortex and the outside femoral diameter had increased at the end of follow-up (P < .001). Wagner SL femoral revision stems can solve difficult cases with major proximal bone defects or periprosthetic fractures. Radiographic bone fixation and bone regeneration were frequent. Dislocations and stem subsidence were also frequent.
我们在股骨翻修手术中使用了79根Wagner SL股骨柄(苏尔寿骨科,瑞士巴尔),并进行了至少5年的随访。发生了11次脱位。肢体长度差异和跛行很常见。有一根松动的股骨柄进行了再次翻修。在最佳情况下,因任何原因无需进行股骨柄翻修的累积概率为92.3%。股骨柄下沉与股骨髓腔填充不佳有关。明确的近端新骨形成(50髋)与无重大骨缺损相关(P = 0.01)。随访结束时,股骨内外侧皮质及股骨外径均增加(P < 0.001)。Wagner SL股骨翻修柄可解决伴有近端重大骨缺损或假体周围骨折的疑难病例。影像学上骨固定和骨再生很常见。脱位和股骨柄下沉也很常见。