Mak Jenson, Solomon Michael, Faux Steven
Eastern Suburbs Private Hospital, Sydney, Australia.
Prosthet Orthot Int. 2008 Jun;32(2):155-9. doi: 10.1080/03093640802015953.
This retrospective file review outlines a case study of an 84 year-old man with a transtibial amputation for vascular disease who underwent an ipsilateral total hip replacement (THR). The question being addressed was how surgical techniques, rehabilitation processes and outcomes of joint arthroplasty would need to vary in a case of an ipsilateral dysvascular amputees. The surgery and associated rehabilitation was undertaken for groin pain, falls and reduced mobility due to mechanical osteoarthritis of the hip. The surgical technique and post-operative multidisciplinary rehabilitation is described in detail. Information on exercise regimes, length of stay and follow-up data on function, driving and pain management is presented. The literature is reviewed and all known cases of THR in amputees as well as data on survival of dysvascular amputees is presented. In light of advances in secondary prevention of vascular disease and cardiovascular surgical techniques, amputees with vascular disease may be living longer than they were 20 years ago. They may be beginning to experience the issues associated with aging such as osteoarthritis of the large joints. This case review and others in the literature may suggest that survival rates for vascular amputees be reviewed.
这项回顾性病历审查概述了一个病例研究，该病例为一名84岁因血管疾病行胫骨截肢术的男性，随后接受了同侧全髋关节置换术（THR）。所探讨的问题是，在同侧血管性截肢患者的情况下，关节置换术的手术技术、康复过程及结果需要如何不同。此次手术及相关康复治疗是针对因髋关节机械性骨关节炎导致的腹股沟疼痛、跌倒及活动能力下降而进行的。详细描述了手术技术及术后多学科康复治疗情况。呈现了关于运动方案、住院时长以及功能、驾驶和疼痛管理方面的随访数据。对文献进行了综述，并列出了所有已知的截肢患者全髋关节置换病例以及血管性截肢患者的生存数据。鉴于血管疾病二级预防及心血管外科技术的进展，患有血管疾病的截肢患者可能比20年前活得更长。他们可能开始出现与衰老相关的问题，如大关节骨关节炎。本病例审查及文献中的其他病例可能表明，血管性截肢患者的生存率有待重新评估。
