Mantelos George, Koulouvaris Panagiotis, Kotsovolos Hlias, Xenakis Theodoros
Department of Orthopedics, University Hospital of Ioannina, Department of Orthopedics, Greece.
Orthopedics. 2008 Jul;31(7):654.
This study evaluates the use of Wagner cementless stem for femurs with marked loss of proximal bone stock. Ninety-five hips in 89 patients were revised with a Wagner stem and prospectively studied. The indications were as follows: aseptic loosening for 84 hips, periprosthetic fracture for 5, Girdlestone for 3, mechanical loosening for 2 and recurrent dislocation for 1. The mean follow-up was 108 months (range, 84-180 months; SD, 13.5). There was only 1 re-revision, 2 months after surgery, and the survival rate at 9 years was 98.5%. The mean Merle d'Aubigné score improved from 8.8 to 16.1 (P<0.001). There were 15 (15.8%) intraoperative fractures, 5 (5.3%) dislocations, 2 (2.1%) thrombosis, and 2 (2.1%) sciatic neuropraxia. Significant bone formation occurred around the Wagner stem in 97% of the hips in these cases. No radiolucency or loosening had been diagnosed at the last follow-up.
本研究评估了Wagner非骨水泥型股骨柄在近端骨量显著丢失的股骨中的应用。对89例患者的95髋采用Wagner股骨柄进行翻修并进行前瞻性研究。适应证如下:无菌性松动84髋,假体周围骨折5髋,Girdlestone手术3髋,机械性松动2髋,复发性脱位1髋。平均随访108个月(范围84 - 180个月;标准差13.5)。术后2个月仅1例再次翻修,9年生存率为98.5%。Merle d'Aubigné评分均值从8.8提高至16.1(P<0.001)。术中骨折15例(15.8%),脱位5例(5.3%),血栓形成2例(2.1%),坐骨神经失用2例(2.1%)。在这些病例中,97%的髋部Wagner股骨柄周围出现明显骨形成。末次随访时未诊断出透光线或松动。