Exeter Hip Unit, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
Int Orthop. 2011 Feb;35(2):267-73. doi: 10.1007/s00264-010-1167-5. Epub 2010 Dec 17.
Advances in surgical technique and implant technology have improved the ten-year survival after primary total hip arthroplasty (THA). Despite this, the number of revision procedures has been increasing in recent years, a trend which is predicted to continue into the future. Revision THA is a technically demanding procedure often complicated by a loss of host bone stock which may be compounded by the need to remove primary implants. Both cemented and uncemented implant designs are commonly used in the United Kingdom for primary and revision THA and much controversy still exists as to the ideal method of stem fixation. In this article we discuss revision of the femur using cemented components during revision THA. We focus on three clinical scenarios including femoral cement-in-cement revision where the primary femoral cement-bone interface remains well fixed, femoral cement-in-cement revision for peri-prosthetic femoral fractures, and femoral impaction grafting. We discuss the clinical indications, surgical techniques and clinical outcomes for each of these procedures.
外科技术和植入物技术的进步提高了初次全髋关节置换术（THA）后的十年生存率。尽管如此，近年来翻修手术的数量一直在增加，预计这种趋势将持续到未来。翻修 THA 是一项技术要求很高的手术，通常因宿主骨量丢失而变得复杂，而这种情况可能因需要移除初次植入物而加剧。在英国，初次和翻修 THA 中通常使用骨水泥固定和非骨水泥固定的植入物设计，关于理想的干骺端固定方法仍然存在很多争议。在本文中，我们讨论了在翻修 THA 中使用骨水泥固定组件进行股骨翻修的问题。我们重点介绍了三种临床情况，包括股骨水泥-水泥翻修，其中主要的股骨水泥-骨界面仍然固定良好，股骨水泥-水泥翻修用于假体周围股骨骨折，以及股骨打压植骨。我们讨论了这些手术的临床适应证、手术技术和临床结果。
