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梅奥保守型髋关节系统的使用经验。

Experience with the Mayo conservative hip system.

作者信息

Hagel A, Hein W, Wohlrab D

机构信息

Klinik für Orthopaedie, Halle, Germany.

出版信息

Acta Chir Orthop Traumatol Cech. 2008 Aug;75(4):288-92.

Abstract

PURPOSE OF THE STUDY

In the development of cementless total hip arthroplasty wear, loosening as well as stress shielding are considered as major issues. New results in literature specify survivorship of THA over 97%. Consequently the implant loosening and wear especially can be considered as almost solved. Therefore, it is essential to use bone preserving primary implants that allow for a physiological load transfer and cause no or only slight stress shielding at the proximal femur. The MAYO conservative hip stem with a wedge design ensuring immediate primary fixation of the stem with metaphyseal load transfer.

MATERIAL AND METHODS

A retrospective study was performed to review the first consecutive 316 MAYO conservative hip stems implanted at the Martin-Luther-University of Halle-Wittenberg (Germany). 85.4% (270 MAYO stems) were radiographic analysed and classified according to the HHS.

RESULTS

The mean HHS improved from 44.79 preoperatively to 93.58 postoperatively. 1.85% (5 MAYO stems) had to be replaced because of aseptic loosening. Furthermore the DEXA scans revealed the metaphyseal load transfer with increased bone density in the calcar region.

CONCLUSION

As especially younger patients will require one or more hip revision procedures during the course of their life due to their life due to their age and activity level. These patients should receive a primary implant with proximal load transfer. Only these implants can avoid stress shielding of the proximal femur. The minimally invasive implantation of these implants can also ensure an enhanced periprosthetic bone density an optimized postoperative rehabilitation phase.

摘要

研究目的

在非骨水泥型全髋关节置换术的发展过程中,磨损、松动以及应力遮挡被视为主要问题。文献中的新结果表明全髋关节置换术的生存率超过97%。因此,尤其是植入物松动和磨损问题几乎可以被认为已得到解决。所以,使用能保留骨质的初次植入物至关重要,这种植入物应能实现生理性负荷传递,且在股骨近端不会产生或仅产生轻微的应力遮挡。MAYO保守型髋关节柄采用楔形设计,可确保柄的即刻初次固定并实现干骺端负荷传递。

材料与方法

进行了一项回顾性研究,以评估在德国哈雷 - 维滕贝格马丁 - 路德大学连续植入的首批316例MAYO保守型髋关节柄。对其中85.4%(270例MAYO柄)进行了影像学分析,并根据美国髋关节协会(HHS)评分进行分类。

结果

平均HHS评分从术前的44.79提高到术后的93.58。1.85%(5例MAYO柄)因无菌性松动而不得不进行翻修。此外,双能X线吸收法扫描显示干骺端负荷传递,股骨矩区域的骨密度增加。

结论

由于年龄和活动水平的原因,尤其是年轻患者在其一生中可能需要进行一次或多次髋关节翻修手术。这些患者应接受具有近端负荷传递功能的初次植入物。只有这些植入物才能避免股骨近端的应力遮挡。这些植入物的微创植入还可确保假体周围骨密度增加以及术后康复阶段得到优化。

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