Tamvakopoulos G S, Servant C T J, Clark G, Ivory J P
Department of Orthopaedics, The Great Western Hospital, Swindon, UK.
Hip Int. 2007 Jul-Sep;17(3):143-9. doi: 10.1177/112070000701700304.
We reviewed a series of 39 patients (40 cases) receiving the Link MP stem in revision hip arthroplasty. Average follow-up was 68 months (range 60-115 months). Proximal femoral defects were classified using the Endo-Klinik and Paprosky classifications. Indications included: osteolysis 13 cases; septic loosening 8 cases; periprosthetic fractures 18 cases; metastatic bone disease 1 case. We found 92.5% overall survival rate, average Harris Hip Score past two years of 67 and average Oxford Hip Score past five years of 43. We found no implant failure or loosening. Complications included: 4 deep infections (2 revised to excision arthroplasty), 5 dislocations (1 revision of the proximal modular segment for impingement). We concluded that revision was successful in cases of peri-prosthetic fractures, septic and aseptic loosening. We advocate use of cerclage wires to prevent peri-operative fractures and use of proximal modular segments with CCD angle of 126 to avoid dislocation.
我们回顾了39例（40髋）在髋关节翻修术中使用Link MP柄的患者。平均随访时间为68个月（范围60 - 115个月）。股骨近端缺损采用Endo-Klinik和Paprosky分类法进行分类。适应证包括：骨溶解13例；感染性松动8例；假体周围骨折18例；转移性骨病1例。我们发现总体生存率为92.5%，过去两年的平均Harris髋关节评分67分，过去五年的平均牛津髋关节评分43分。我们未发现植入物失败或松动情况。并发症包括：4例深部感染（2例改为关节切除成形术），5例脱位（1例因撞击对近端模块化节段进行翻修）。我们得出结论，在假体周围骨折、感染性和无菌性松动的病例中翻修是成功的。我们主张使用环扎钢丝预防围手术期骨折，并使用颈干角为126°的近端模块化节段以避免脱位。
