Learmonth Ian D
University of Bristol, Honorary Consultant University Hospitals Bristol NHS Foundation Trust and North Bristol NHS Trust, UK.
Hip Int. 2009 Jul-Sep;19(3):195-200. doi: 10.1177/112070000901900301.
Arthritis of the hip primarily involves the joint surfaces. Intuitively the principal objective in the surgical management of arthritis is to replace the damaged articular surfaces. However, early attempts at conservative replacement failed both because of inadequate fixation and failure of the articulation.Conservative hip implants take less bone at the time of surgery and preserve bone in the longer term with more physiological loading. In addition, the implants are usually easier to insert with soft tissue sparing surgery. While these implants potentially offer an additional option in the surgical management of younger patients with arthritis, this advantage is negated if there is an unacceptably high incidence of premature failure. This paper explores the evolution and results of conservative total hip prostheses that culminated in the contemporary designs.
髋关节关节炎主要累及关节面。直观地说，关节炎外科治疗的主要目标是替换受损的关节面。然而，早期保守置换的尝试均告失败，原因既有固定不充分，也有关节连接失败。保守型髋关节植入物在手术时所需骨质较少，从长期来看，通过更符合生理的负荷可保留骨质。此外，采用保留软组织的手术方式时，这些植入物通常更容易植入。虽然这些植入物可能为年轻关节炎患者的外科治疗提供了额外选择，但如果过早失败的发生率高得令人无法接受，这一优势就会被抵消。本文探讨了保守型全髋关节假体的发展历程及最终形成当代设计的结果。
