Girard Julien, Riera Philippe, Pearce Olivier, Duquennoy Antoine, Migaud Henri
Orthopaedic Department C, Roger Salengro Hospital, Lille, France.
Hip Int. 2011 Jan-Mar;21(1):14-20. doi: 10.5301/hip.2011.6274.
To address femoral bone loss in revision total hip arthroplasty (THA) we developed a technique involving impaction allografting with intramedullary mesh moulded around the revision stem, to prevent excessive cement penetration of the allograft. The length of the revision stem was determined by the extent of femoral bone loss. Between 1986 and 1998, 32 such procedures were undertaken on 28 patients. The mean pre-operative HHS for function was 22 (range 5 to 42), improving to 41 (range 12 to 47) at final follow-up. Only 1 patient presented with aseptic loosening after revision at 147 months (12.2 years). The 12.5 year survivorship for the stem was 92.8%. The technique has provided stable and durable reconstruction, with good new bone formation visible radiologically. It is technically demanding and time consuming, but it avoids the previously published problem of massive subsidence within the bone graft.
为解决翻修全髋关节置换术（THA）中股骨骨质流失的问题，我们开发了一种技术，该技术包括使用围绕翻修柄模制的髓内网进行嵌压植骨，以防止骨水泥过度渗入植骨。翻修柄的长度由股骨骨质流失的程度决定。1986年至1998年间，对28例患者进行了32次此类手术。术前功能的平均髋关节 Harris 评分（HHS）为22分（范围为5至42分），在末次随访时提高到41分（范围为12至47分）。仅1例患者在翻修后147个月（12.2年）出现无菌性松动。柄的12.5年生存率为92.8%。该技术提供了稳定而持久的重建，影像学上可见良好的新骨形成。该技术要求高且耗时，但避免了先前报道的骨移植内大量下沉的问题。
