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改良水泥间隔器技术治疗伴有严重骨质丢失的感染性全髋关节置换术。

A modified cement spacer technique for infected total hip arthroplasties with significant bone loss.

机构信息

Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.

出版信息

J Arthroplasty. 2012 Apr;27(4):613-9. doi: 10.1016/j.arth.2011.06.031. Epub 2011 Aug 31.

Abstract

Complications related to femoral spacers are common during addressing infected total hip arthroplasties by 2-stage revision. We evaluated 11 patients who had 2-stage revisions with massive bone loss after removal of the infected components by a trochanteric osteotomy. All femoral cement spacers were assembled on intramedullary nails. Femurs were protected by a plate, whereas acetabuli were augmented by a cage or roof ring depending on the remaining bone stock. This additional hardware was covered with antibiotic-impregnated cement. Infection was eradicated in 10 (90.9%) of 11 patients within 3.5 months in average. None of the patients had spacer fracture, periprosthetic fracture, or dislocation. Augmentation by hardware covered with antibiotic-impregnated cement is effective and may reduce complications until definitive treatment is performed.

摘要

在通过两阶段翻修术解决感染性全髋关节置换术后,与股骨间隔器相关的并发症很常见。我们评估了 11 例患者,他们在通过转子间截骨术去除感染性成分后,发生了大量骨丢失,进行了两阶段翻修术。所有股骨水泥间隔器都装在髓内钉上。股骨用钢板保护,髋臼根据剩余骨量用笼或顶环增强。额外的硬件用抗生素浸渍的水泥覆盖。11 例患者中有 10 例(90.9%)在平均 3.5 个月内消除了感染。没有患者出现间隔器骨折、假体周围骨折或脱位。用抗生素浸渍水泥覆盖的硬件增强是有效的,可以减少并发症,直到进行确定性治疗。

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